On December 22, 2023, the Cuban Parliament approved a new Public Health Law, which replaces the 1983 law and among its singularities is the possibility for seriously ill patients on the island to request euthanasia or assisted suicide.
No, these words are not literally in the cool text. The president of the Cuban Society of Civil and Family Law, Leonardo Pérez Gallardo, one of the participants in the “debate” on the new norm – which, as expected, ended with the unanimous favorable vote of the 470 deputies – she announced as if the omission of the concept of euthanasia or the use of a euphemism mitigated the seriousness of the phenomenon: “Terms like euthanasia are avoided in the expression of the legal norm, and the plural is used, which is important: determinations”, he said.
Pérez alluded to article 159.1 of the new law: “The right of people to access a dignified death is recognized, through the exercise of end-of-life determinations, which may include the limitation of therapeutic effort, continuous or palliative care and valid procedures that end life, aimed at people with chronic degenerative and irreversible diseases, with intractable suffering, who are in an agonizing or terminal phase of life or who have suffered injuries that place them in this condition”.
To make this possible, the approval of “standardized protocols for multidisciplinary action” was announced, which will only be applied “when it is determined by the Ministry of Public Health that the conditions are created to carry out these actions in the country”.
Extreme poverty? Pain? Here is the output
The aforementioned unanimity in the vote on “dignified death” may respond, in the Cuban case, both to Cuba's parliamentary tradition of approving absolutely everything that the communist regime decides must be carried out, and to the radically materialist philosophy that – via education and coercion – has permeated social consciousness since 1959, and identifies dignity with the individual’s full physical and mental autonomy and the absence of all pain.
Faced with a serious shortage of medicines, many people in Cuba are turning to social media to ask someone to sell or donate antipsychotics, blood pressure medicine and even strong painkillers against cancer.
A rule of this type arrives precisely when the material and psychological well-being of Cuban citizens is seriously affected by decades of economic crisis, which has worsened since the government of former US President Donald Trump (2017-2021) was directly against the financing methods of the communist system. Like foreign tourism, for example, which in turn was favoring the take-off of small businesses and the independence of citizens in relation to the Government. The death knell was given by the Covid-19 pandemic and a calamitous economic reform – known as the “Reordering Task”, enacted at the beginning of 2021 – which set out to eliminate the monetary duality that existed in Cuba since 1994, but which, given The country's chronic low productivity has had devastating effects on the economy of millions of homes, mainly in terms of food and health.
To get an idea of the gravity of the situation, it would be enough to quote the price of a basic food: the egg. In the informal market, which is the only one where it can be obtained, a tray with 30 units is being sold for 3 thousand Cuban pesos (11 euros at the current exchange rate), while the minimum wage on the island is 2.1 thousand Cuban pesos (8 euros). Even more difficult to bring to the table are meat, dairy products, seafood… These deficiencies significantly lower nutritional levels and have a fundamental impact on the physical and mental health of people with disabilities and elderly people who live alone.
The problem is worsened by the shortage of hundreds of medicines that the local pharmaceutical industry can no longer produce nor can the country afford to import. In July 2023, the president of the state-owned company BioCubaFarma, Eduardo Martínez, informed the Cuban Parliament that there was a shortage of 251 pharmaceuticals in the country: 40% of the island's medicine supply. After the report, some deputies advocated resorting to “natural and traditional medicine”, but many relatives of sick people prefer to use social media to ask someone outside to sell or donate medicines to them, both antipsychotics and blood pressure medicines and strong painkillers against the cancer. Why not: no one wants to live in torment, nor to die before their time, but rather to have their pain alleviated.
Evidently unable to relieve so many at this time, the communist system chose to teach patients almost a single door. The wrong door.
Today, for the seriously ill; tomorrow, for others
With a rate of 14.5 suicides per 100,000 inhabitants, Cuba is above the world average (9.2 per 100,000) in records from the World Health Organization (WHO) corresponding to 2019. In these, it shares position with developed countries such as Switzerland and Austria (14.5 and 14.6), and is below the USA (16.1).
In your 2022 Statistical Yearbook, the Cuban regime offers more current and “less bad” figures: that year, suicide was the tenth cause of death (1,432 people; the rate was 12.9). But with the emergence of assisted suicide or euthanasia at a date yet to be determined, the asphyxiating economic circumstances, the precariousness of the health system and circumstances such as the growing loneliness or isolation of the elderly population – between 2022 and 2023 alone, almost half a million of Cubans moved to the USA, most of them of working age – may lead to greater interest on the part of the poorest, the abandoned and the disabled in this “way out” of their afflictions.
It wouldn't be strange if they saw it that way, judging by the experiences of other countries. In Canada, according to explained to Catholic News Agency (CNA, its acronym in English) Alex Schadenberg, director of the Euthanasia Prevention Coalition, the law provides that “almost anyone with a chronic illness (such as people with disabilities) can be approved for euthanasia.” It is thus, he says, that poverty, lack of housing or the unavailability of certain medical treatment are the real reasons why some disabled people ask for death, “but euthanasia is approved because of their disability”.
Meghan Nicholls, executive director of the Mississauga Food Bank, located in the province of Ontario, Canada, reinforces this statement with what she herself sees among the people her institution helps: “We are at a point where clients These programs tell us they are considering medically assisted death or suicide because they can no longer live in extreme poverty. […] A client of our Food Bank 2 home delivery program told one of our employees that he
is considering suicide because he is tired of suffering in poverty. Another client asked if we knew how to request MAID (medical assistance in dying) for the same reasons.”
If this happens in one of the seven richest countries in the world, what will be left for those inhabitants of a Caribbean island who do the math and see that their retirement pension is not enough to buy a tray of 30 eggs?
It will certainly be said that the law is clear: the procedure is intended for “people with chronic degenerative and irreversible diseases, with intractable suffering”, etc., etc. However, these “clear” limits to euthanasia were initially established in several countries, which inevitably ended up sliding downhill and expanding the application assumptions from time to time. Is Cuba the exception?
Loose ends for crime
Lastly are the errors. And bad faith. Of the former, there are suspicions, if not evidence, in cases occurring in Belgium and the Netherlands; situations in which protocols were applied lightly, as happened in 2010 with the young Belgian Tine Nys, whom the Federal Commission for the Control and Evaluation of Euthanasia quickly approved his request for the procedure, rather than waiting the mandatory month; or the case of a old dutch woman who, when receiving the injection, resisted, leading her family to immobilize her so that the doctor could administer the lethal medication.
An eminent Cuban neurologist, Dr. Calixto Machado, had already warned about irregularities of this type – which in these countries, with division of powers, led to legal proceedings -, back in 2019, when euthanasia, as a legal possibility, began to be a topic of interest to the communist regime.
In a popular television program, Machado, then president of the Cuban Society of Clinical Neurophysiology and the National Commission for the Determination and Certification of Death, it was direct: “The legalization of euthanasia (I don’t believe just in our country, but in many parts of the world) will leave loose ends for crime. […] To offend. An elderly person who lives with family, with a large inheritance, and with prostate cancer, could be led by these family members to sign a document approving his euthanasia so that they [os familiares] could have his inheritance.”
For Machado, the focus should be on the need to develop palliative care for critically ill patients. It is possible to do, he said, “many therapeutic activities to mitigate pain in these patients; palliative sedation is performed, for example, by oncologists” – and it was essential to accompany them. With pain controlled and loneliness overcome, “on many occasions, these people's thinking changes and they no longer want to die”, he assured.
There are many examples of this, but, in that plenary meeting in Havana, the disciplined applause in favor of the false “dignified death” prevented them from being heard.
© 2023 Aceprensa. Published with permission. Original in Spanish.
#Euthanasia #settles #silently #Cuba
