Право на эвтаназию в различных странах

Sungatullina A.A.,
Student at the Russian State University of Justice

Scientific consultant Parfenenko E.N.,
Associate Professor  at the Foreign Languages Department,
Russian State University of Justice, PhD in Philology

Right to euthanasia in different countries

Executive summary. The article is focused on the legal regulation of euthanasia in the Russian Federation and other countries. Over time, an increasing number of countries allow people to use euthanasia. However, in Russia, this method of termination of life remains prohibited. This research provides arguments “for” and “against” such practice. The authors conducted a social study to determine the attitudes of Russian citizens towards the legalization of euthanasia. Based on the examples of other countries, it is proposed to amend the existing Russian legislation in order to allow people to choose how they want to dispose of their lives. In writing the article, the authors used the comparative method, comparing different legal systems, as well as the modeling method, in conducting a social survey. According to the survey, the majority of respondents believe that euthanasia should be officially allowed in Russia.

Keywords: euthanasia, law, legalization, death, doctor, suicide, illness, life, murder.

Human beings are by nature mortal. And sooner or later, death will come to all of us. But no one has the right to take our life. We all have the right to live. We have the right to use our life as we wish as long as our actions do not violate the rights of others. But do we have the right to take our life? Do we have the right to die? Not only are human beings mortal, but unfortunately they tend to be prone to illnesses of various degrees of seriousness. The terrible suffering and anguish that a patient experiences may not allow them to think of anything other than a way to make their pain go away. And one of those ways is euthanasia. The term “euthanasia” means any action committed or omitted for the purpose of causing or hastening the death of a human being after birth, usually for the alleged purpose of ending the person’s suffering. The word derives from two Greek words: “Eu” meaning “easy” and “thanos”, which means “death”[2]. Euthanasia is an act of deliberately ending a person’s life to relieve suffering. A doctor who gives a patient with terminal cancer an overdose of muscle relaxants to end their life, would be considered to have carried out euthanasia [7].

Assisted suicide is an act of deliberately assisting or encouraging another person who commits, or attempts to commit, suicide. If a relative of a person with a terminal illness were to obtain powerful sedatives, knowing that the person intended to take an overdose of sedatives to kill themselves, they would be assisting suicide [7].

There are two types of euthanasia, active and passive. When most people think of euthanasia, they think of a doctor directly ending someone’s life. This is known as active euthanasia. Purposely giving someone a lethal dose of a sedative is considered active euthanasia [11]. Passive euthanasia is sometimes described as withholding or limiting life-sustaining treatments so that a person passes more quickly. A doctor may also prescribe increasingly high doses of pain-killing medication. Overtime, the doses may become toxic [11].

Euthanasia is a controversial, difficult topic. There is a rather contradictory view on this in the international community. In most countries, euthanasia is prohibited in any form. However, as the practice becomes more widespread and its rationale becomes clearer, public opinion is quickly changing.

These are the jurisdictions where either euthanasia or assisted suicide is legal.

In the countries shown, the condition for euthanasia is the last stage of the illness with no signs of improvement. The medications used vary from country to country, but the process is essentially identical. A combination of anesthesia and a powerful barbiturate or sedative (typically phenobarbital) ensures that the patient falls into a deep sleep prior to succumbing to cardiac arrest from the barbiturate [10]. In the vast majority of countries, patients may choose to die at home or in a healthcare facility. An example of a legislative act that legalized euthanasia is the Belgian law on euthanasia, which was passed in 2002. It provides the necessary conditions and procedure for performing euthanasia.

In order to carry out euthanasia, a number of conditions must be met, which are monitored by the doctor treating the patient. First of all, the patient must be an adult or a legally capable minor. Secondly, there must be a voluntary request of the patient that has been made repeatedly. Furthermore, the patient must be in severe distress and there is no possibility of improvement. Obviously, the doctor must be aware of the patient’s illness and their current condition. It is also important to realize the hopelessness of the situation, which manifests itself in the inability to find an alternative to the end of life. Last but not least, to perform euthanasia the opinion of an independent doctor is required. If the procedure is carried out, end-of-life care must also be provided.

To begin with, in order to die by euthanasia, the patient must make a request in writing, which can be changed or withdrawn at any time. After this the doctor must consult with other independent doctors. Оn top of that the doctor must ensure that the patient has had the opportunity to discuss his or her request with the closest relatives and other persons close to the patient. It is important that at least one month should elapse between the written request of the patient and the execution of euthanasia. The euthanasia procedure comes with certain features that should be mentioned. A person who dies as a result of euthanasia carried out under the conditions laid down in the Act is considered to have died a natural death in respect of contracts to which he or she was a party, and in particular insurance contracts.

Whereas legal regulation of euthanasia is evolving around the world, this is not the case in Russia. According to Article 45 of the Federal Act “On the fundamentals of protecting the health of citizens in the Russian Federation”, medical workers are prohibited from performing euthanasia, i.e. hastening, at the request of a patient, his or her death by any act (or omission) or means, including stopping artificial measures to keep the patient alive [4].

However, article 21(2) of the Constitution of the Russian Federation states “no one shall be subjected to torture, violence or other cruel or degrading treatment or punishment” [3].

Since the pain and suffering of the patient in severe cases can be called real torture, being in such an unflattering state in the presence of others, especially if the patient is being visited by someone highly respected, can be humiliating for the patient. In such a case, the only way to prevent this torture in a desperate situation would be euthanasia.

There are arguments in society both in favour and against euthanasia. According to Nargus Ebrahimi from University of New South Wales, there are Rights-based argument for euthanasia.The advocates of euthanasia argue that a patient has the right to make the decision about when and how they should die, based on the principles of autonomy and self-determination [1, 6]. Another argument isbeneficence.It is said that relieving a patient from their pain and suffering by performing euthanasia will do more good than harm.

There are also arguments against the legalization of euthanasia.The first one isthe sanctity of life.Central to the argument against euthanasia is society’s view of the sanctity of life, and this can have both a secular and a religious basis [12]. The underlying ethos is that human life must be respected and preserved [1]. Another opinion is that euthanasia is a murder.Society views an action which has a primary intention of killing another person as inherently wrong, in spite of the patient’s consent. In addition, there may beabuse of autonomy and human rights.Some people think that patients’ requests for euthanasia are rarely autonomous, as most terminally ill patients may not be of a sound or rational mind [9]. Some people are also afraid of worsening doctor-patient relationships and changing the doctor’s role.Active voluntary euthanasia and physician-assisted suicide undermine the doctor-patient relationship, destroying the trust and confidence built in such a relationship. A doctor’s role is to help and save lives, not end them [1].

In order to find out the opinion of Russian citizens, a survey was carried out in the form of a social interview with 310 people between the ages of 15 and 67. The vast majority of the respondents were young people between the ages of 16 and 21 inclusive. Obviously, people in this age group were more concerned about this issue, as it could affect the future of the country. It is the young people who will have to make changes in the life of the country in the future. To start with, the respondents were asked if they knew anything about euthanasia, or if they had heard about it for the first time. 76% knew about it, 17% had heard something, 6% knew about it for the first time and 1 person could not answer. The main question was whether they considered it acceptable to officially allow euthanasia in Russia. 70% considered it acceptable, 15% considered it unacceptable and the rest had difficulty answering.

Most respondents considered euthanasia acceptable as they thought a person has the right to control his or her own life and people should not have to suffer or to be tortured of their own free will. Those who considered euthanasia unacceptable admitted that there may be medical mistakes in determining the illness and that people should fight for life until the end. Some respondents also admitted that there might be abuses or crimes and that euthanasia is murder or suicide.

The next question that should be mentioned is whether Russian citizens could ask for euthanasia. About half of those surveyed could ask for it, the rest could not, or had difficulty answering.

In conclusion, people generally consider it acceptable to officially allow euthanasia in Russia, as a person can dispose of his or her own life and does not have to suffer horrible torture. However, there are those who are against it. They are afraid of an unusual and morally difficult procedure. Some believe in a miracle and hope for a better outcome. In our opinion, when the chances of recovery and alternatives are clearly non-existent, the only option is to perform euthanasia under the conditions necessary to prevent possible crime and other negative consequences.

Литература

1. Bartels L, Otlowski M. A right to die? Euthanasia and the law in Australia. J Law Med. 2010 Feb; 17(4):532-55.

2. Brian Clowes. An Introduction to the Problem of Euthanasia. April 17, 2020. EDN RRJGLT. URL: https://www.hli.org/resources/types-of-euthanasia-intro/ (дата обращения 24.10.22).

3. Constitution of the Russian Federation Federal law of 21.11.2011 N 323-FZ (as amended on 11.06.2022, as amended on 13.07.2022) “On the fundamentals of health protection in the Russian Federation” (as amended and supplemented, in force from 01.09.2022).

4. Federal Law No. 323-FZ of November 21, 2011 (as amended on December 28, 2022) “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation” (as amended and supplemented, effective from January 11, 2023);

5. Goldman L, Schafer AI, editors. Goldman’s Cecil Medicine. 23rd ed. USA: Saunders; 2008. Chapter 2, Bioethics in the practice of medicine; p.4-9.

6. Kerridge I, Lowe M, Stewart C. Ethics and law for the health professions. 3rd ed. New South Wales: Federation Press; 2009.

7. Lebedeva, O. D. Euthanasia or assisted suicide? / O. D. Lebedeva // Bulletin of Medical Internet Conferences. - 2013. - Т. 3. - № 11. - С. 1273. –

8. Moniteur Belge – Belgian Official Journal. The law on euthanasia in Belgium. URL: https://www.ejustice.just.fgov.be/cgi/article_body.pl?language=nl&pub_date=2002-06-22&numac=2002009590&caller=summary (дата обращения 25.10.2022).

9. Patterson R, George K. Euthanasia and assisted suicide: A liberal approach versus the traditional moral view. J Law Med. 2005 May;12(4):494.

10. Willis K.The Complete Guide to Euthanasia in 2022: When is it Legal? Expert DNA & Health Test Researcher. URL: www.dnaweekly.com/blog/complete-guide-euthanasia-where-how-when-legal/ (дата обращения 24.10.22).

11. Timothy J. Legg, Kimberly Holland. Euthanasia: Understanding the Facts. Updated on May 31, 2019.

12. Walsh D, Caraceni AT, Fainsinger R, Foley K, Glare P, Goh C, et al. Palliative medicine. 1st ed. Canada: Saunders; 2009. Chapter 22, Euthanasia and physician-assisted suicide; p.110-5.

13. What’s the difference between assisted suicide and euthanasia? BBC journal, February 8 2019.