Filenews 16 October 2021 - by Despina Psilou
Turmoil, reactions and concern has caused the opening of the euthanasia dossier in Cyprus. The dilemma between the life and the redemption of a patient who is slowly dying in a painful way is characterized by everyone as a multidimensional issue that deserves attention. Organized patients recognize the right to euthanasia, with reservations. The Pancyprian Medical Association also appears cautious, underlining the complexity of the issue and the need to protect the doctors who will be involved in such a procedure. The participation of a Court to decide on the basis of opinions on the euthanasia of an applicant, considers as the most balanced solution the psychiatrist George Mikellidis. At the same time, the Church is clearly against, speaking of murder and suicide. The issue of euthanasia came to the fore as it was registered for discussion in the Human Rights Committee by MPs Irene Charalambidou and Alexandra Attalidou.
"We submitted an ex officio issue for discussion on euthanasia in Cyprus," said the MP of the Movement of Ecologists, Alexandra Attalidou, noting that there are several people who saw very close to them reaching death through a very excruciating route and at the same time, because there are people who know that the evolution of their health has a very difficult end in store for them. "People approached me about this. I know, in fact, some people who have been in contact with a centre in Switzerland so that they can proceed with euthanasia."
As he said, they refer to patients who are in the last stage and whose condition is not reversible. They are sure to die. "In the Convention on Human Rights, there is an article, which states that people must be protected from torture, and pain. That no one should suffer. There is care to protect them. Even if it is not a person who torments you, but a disease. Palliative medicine may have made progress, but there are people who suffer immensely at the end of their lives and who may express the right to end their lives sooner, either so that they do not go through the torment themselves, or so that their family does not go through it."
Abroad, Ms Attalidou said, there is the possibility for a person, while he is well, to sign a form stating that in case he falls into a condition he does not wish to be connected to a support machine. There is also the option of someone refusing to receive treatment.
On his part, the chairman of the Ethics Committee of the Pancyprian Medical Association (PIS), Michalis Anastasiades, spoke about a subject with many aspects, which needs extensive study. "It has preoccupied the global scientific community and needs proper information, awareness and safeguards," he said, and cited as an example that "medical consent cannot be not sought if it is a request of a chronic patient. Of course, in order for this medical euthanasia to be able to be given, specific medical and scientific criteria must be set. Therefore, it is not just a question of human rights and an attempt to ease the pain of a chronic sufferer. The matter needs a lot of consideration."
As he said, the debate may begin with a good intention. "With the thought of supporting people who are in the final stages of a chronic and painful disease, as an attempt to ease their pain, however, many issues are involved. Even the way of euthanasia has preoccupied the scientific community." From a medical point of view alone "there are too many parameters and too many factors that need to be counted, before a treating doctor consents to such a decision," he said, adding that each case should be considered individually.
He also said that the doctor who will be asked to give his consent or even his opinion, bears a great responsibility. For this reason, the safeguards for the protection of doctors are a "necessary condition". Otherwise the Medical Association will not consent. And it goes without saying that the doctor must feel covered, beyond the medical and legal responsibilities and the responsibilities of the medical professional, responsibilities that cover the moral and bioethical side of the issue. For us, the whole thing is not just an individual decision. It's a decision that concerns the whole family."
He also said that euthanasia should come as an option, after all the measures that science can provide for either medical or psychological support have been exhausted. "The State should find ways to relieve these pained individuals."
Murder and suicide seen by the Church
The Church of Cyprus is against euthanasia, stating that no man should decide on his death or on the death of someone else. As noted in "F" the president of the Synodal Committee of Bioethics of the Church of Cyprus, Metropolitan Georgios of Pafos, it is an act of murder when decided by a doctor and an act of suicide, when decided by the patient. "The problem is that people put quality of life above its value." However, he emphasizes, life is self-worth. After all, he said, from a Christian point of view, pain and sorrow are within God's plan for the salvation of the soul. "Many times pain led to salvation, rather than well-being."
The Church, he said, is against euthanasia for reasons of principle. "Only God, who gives life, can take it." In fact, there is a wish that when life becomes unbearable for someone, God will take care of him and take him to him. Moreover, he said, repentance is essential for the Church. "He can seek repentance in this pain and inherit eternal life. It's not just the well-being."
On euthanasia, he said that "if the patient does not give his consent and the doctor or relative proceeds this is murder. If the patient himself asks to be led to death, then it is suicide." After all, he said, it is dangerous to be able to make the decision for someone else to die.
'To be decided by a Court of Justice'
The psychiatrist Giorgos Mikellidis also expressed strong concerns. "The best thing that could be done is to rely on the court to consider the euthanasia request, based on medical and psychiatric assessments. I believe it would be preferable to have a procedure through a Court of Justice to ensure that there are no abuses, which will result in the death of a person." In other words, the person is protected, explains Mr. Mikellidis, from any benefit of a third party. "Better control will be ensured through the Court, if there is legislation."
It's important how one wants to live one's life, it's important and the right to euthanasia, he said, while also talking about a doctor's moral conflict. "All doctors struggle every day to keep people alive. All of us talk about the right to life and do everything we can to protect it. Euthanasia is something completely different. It is in a way the right to death. We have to be very, very careful if the person has the critical ability to decide on such matters and if the person has a mental disorder that prevents his judgment."
As he said, there are mental disorders, such as personality disorders, which present chronic suicidal ideation and often a history of attempted suicide. After all, he said, "when someone wants to commit suicide, he can be taken to a psychiatric hospital to be given treatment if he suffers from a mental disorder and eventually with the improvement of his condition he can stop wanting to die. So everything has to be checked."
The OSAK recognises the right
The right to euthanasia is recognized by the President of the Federation of Cyprus Patients' Associations, Marios Kouloumas, while maintaining several reservations. "It's a right that we need to look at very, very carefully and reflect on how it can be done."
A prerequisite, he noted, is intensive control for each case. "For example, we may have a bedridden patient who has no relatives. This man, because of the poor quality of his life can rule that he can not stand it any longer and that he wants to die. However, in reality it is not his state of health that leads him to this poor quality of life and by extension to this desire to die, but the lack of support from the State and society", he said and clarified that the despair of this man lies in social causes and not medical ones.
"That's why a lot of care is needed. It is very easy to get to such a point. The person can, with the proper support and proper care, acquire a bearable standard of living that will not justify its termination." Many patients, he said, are driven to despair about this and we need to strengthen the social state and support, create a network for these individuals.
The issue is a matter of concern to the ECtHR - What prevails in the EU countries
In Cyprus there is no legislation or a constitutional right to death, lawyer Alexandros Clerides told "F", adding that "we have the absolute right to life". As he said, the issue of euthanasia is a matter of concern to the European Court of Human Rights, which to date seems not to be prepared to put other rights above the right to life. He explained, at the same time, that the conflicting rights lie in not being subjected to torture or degrading treatment, which you can claim to be the outcome of a fatal disease.
As for the EU countries, he noted that the most recent developments are taking place in Spain and Germany. "In Spain, euthanasia has been officially legislated in a positive way and is now considered legal. In Germany, the Supreme Constitutional Court has ruled as unconstitutional the law prohibiting assisted suicide, but not euthanasia." The Netherlands, he says, is perhaps the first country to have legalized such practices and to this day continues to provide such services to a great many people. There are even thoughts of legalizing euthanasia in people under the age of 12. "In the Netherlands, 6,361 people chose euthanasia during 2019."
As he said, the European Court of Justice in some very important judgments that examined the issue of euthanasia and how it is interpreted through the articles of the European Convention for the Protection of Human Rights, came to decide that the right to the protection of life cannot be interpreted as conferring the right to death. Therefore, Article 2 of the Convention is above all the other articles, meaning that it prevails over the protection of inhumane treatment, freedom of expression, freedom to contribute.
In addition, Mr. Clerides referred to Switzerland (a non-EU country), clarifying that euthanasia is prohibited, however, assisted suicide is allowed by legislation of 1937. Citing a survey, he said that a total of 81.7% of respondents supported the legality of assisted suicide, as is currently the case in Switzerland, and 60.9% said they would consider possibly requesting assisted suicide under certain circumstances. 28.2% of respondents reported either that they are already or that they are likely to become members of death rights organizations, while 4.9% of respondents reported that they were already members of such an organization at the time of the survey.
