Assisted suicide, also known as euthanasia, remains illegal in South Africa.
Dr Helena Dolny, the co-founder of Love Legacy Dignity, explains that euthanasia involves individuals choosing to end their lives in the face of unbearable suffering, often due to terminal illness or severe disability.
Dolny weighed the pros and cons of the practice and cautioned against illegal assistance in such acts, referencing the case of a young man who ended his own life in a manner she describes as “cruel”.
Despite the ban in South Africa, which an eNCA report confirmed, the reality is that it is different elsewhere, prompting individuals like Carol de Swardt to seek solace in countries with more lenient laws.
Suffering greatly from skin cancer diagnosed in 2010, De Swardt’s pain worsened following the amputation of her leg due to excessive radiation treatment, as reported by George Herold.
The 63-year-old expressed a loss of will to continue living under such conditions.
In a heartfelt account, it was revealed that De Swardt’s two children stood by her decision to undergo assisted suicide, and had been accompanying their mother in her final days.
The procedure was scheduled for Wednesday, January 31, in Switzerland.
Dolny’s discussion with eNCA highlighted the complex and emotional nature of the decision, which is influenced by personal circumstances such as living a full life before encountering a life-altering condition.
She said the importance of the words chosen to describe the services, as “assisted suicide” and “assisted dying” carried different meanings.
Discussing the language used to talk about euthanasia, Dolby that terms like “assisted suicide” and “assisted dying” might not effectively convey what the service really meant.
The issue often arose for those who had lived a full life but then faced a dreadful condition like terminal cancer or a severe disability that made them wish to end their suffering.
Dolny cited the story of a man in his twenties who had neurofibromatosis.
She said he might have lived for many more years but had struggled a lot and, ultimately, ended his life in a way she believed was cruel – suffocating himself with a plastic bag.
She said his story illustrated the consequences of laws forbidding any help in such situations.
Assisted suicide, often referred to as physician-assisted death or aid in dying, is where a physician provides a competent terminally ill patient with a prescription for a lethal dose of medication, which the patient then self-administers to end their own life.
Not all countries permit the practice of euthanasia and in those that do permit it, it often comes with strict regulations and guidelines.
Below are examples of how assisted suicide is approached in jurisdictions where it is legal:
Switzerland
Assisted suicide is legal and unique in that it is open to non-residents. Swiss law requires that the act must be performed without selfish motives and the person seeking assisted suicide must have decisional capacity.
Canada
Medical assistance in dying is legal and includes the option of assisted suicide and euthanasia (where the physician administers the substance).
Patients must meet certain criteria, including being at least 18 years old, having a grievous and irremediable medical condition, and having made a voluntary request.
The Netherlands
Euthanasia and assisted suicide are legal under strict conditions. Patients must be enduring unbearable suffering with no prospect of improvement. Two doctors must agree on the condition’s severity.
Belgium
Similar to the Netherlands, euthanasia and assisted suicide are legal. The requirements include constant and unbearable physical or mental suffering that cannot be alleviated.
Luxembourg
It follows a similar protocol to Belgium and the Netherlands.
Colombia
Euthanasia is legal for patients with terminal conditions or intense suffering, and in 2021, the right to die through euthanasia was extended to include non-terminal patients who suffer from intense physical or mental suffering.
Austria
Following a court ruling, euthanasia and assisted dying are allowed under specific circumstances.
Spain
Euthanasia and assisted suicide are legal for adults with serious and incurable conditions causing intolerable suffering.
Germany
In 2020, the country’s Federal Constitutional Court ruled that a ban on professional assisted suicide was unconstitutional.
New Zealand
Assisted dying was legalised following a 2020 referendum and under the End of Life Choice Act took effect in 2021, for terminally ill patients with fewer than six months to live.
In the US, assisted suicide laws vary by state: Oregon was the first US state to legalise physician-assisted suicide under the Death with Dignity Act.
Washington DC, California, Colorado, Hawaii, Maine, New Jersey, New Mexico and Vermont.
In all cases where assisted suicide is legal, there are a series of procedural safeguards, and the patient must be deemed to be making an informed and voluntary decision.
The safeguards often include waiting periods, the need for second opinions, psychological evaluations and age restrictions. Furthermore, physicians are typically required to inform the patient of alternative options, including palliative care.
Pros of euthanasia include:
Alleviation of suffering: Euthanasia can bring relief to patients who are suffering from intolerable pain or an incurable illness, providing a dignified end to their life.
Right to choose: Advocates argue that individuals should have the autonomy to decide their fate, including the right to end their life on their own terms when facing terminal illness.
Medical resource allocation: By allowing euthanasia, health-care resources can be reallocated to patients with better chances of recovery, reducing the burden on overstretched health-care systems.
Psychological relief: For some terminally ill patients and their families, knowing the option of a peaceful and controlled death is available can offer psychological comfort.
Potential reduction in under-the-table practices: Legal euthanasia might reduce the occurrences of unethical practices where patients are covertly assisted to die without proper regulation and oversight.
Cons of euthanasia include:
Ethical concerns: Euthanasia raises moral questions about the value of life and whether it’s ever justifiable to take a life, even with consent.
Potential for abuse: There is a risk that the system could be misused, leading to non-voluntary euthanasia, especially among vulnerable groups like the elderly, disabled or those unable to consent.
Slippery slope argument: Some posit that the legalisation of euthanasia could lead to a gradual erosion of respect for life and may result in broadening the criteria for eligibility beyond the terminally ill.
Religious and cultural beliefs: Many religions and cultures hold strong beliefs in the sanctity of life, viewing euthanasia as morally wrong.
The debate on euthanasia involves complex ethical, moral, legal, medical and personal factors, and the pros and cons must be carefully weighed in the context of the society and individuals involved.