There are less than ten countries around the world that contemplate medically assisted death for people who want to end their life due to a health condition. However, euthanasia has been present throughout our history, although now it is sought to debate it openly in a society where death is synonymous with defeat.
In Greek, “eu” means good and “thanatos” translates to death. Thus, the very etymological origin of the word reveals what lies behind euthanasia: dying well. The debate around assisted death has been gaining strength for years, especially in a society where old age is getting longer and longer, both for the defenders of the so-called dignified death and for its detractors.
When we talk about a dignified death, “we talk about the right to decide how we want the end of our lives to be.” This is how Camila Jaramillo, a lawyer at DescLAB in Colombia, speaks.
Something that may sound simple actually has many edges: it includes access to palliative care during the last period of illness, the autonomy to refuse some treatments that could prolong life, and medically assisted death.
Under the umbrella of assisted dying, there are two possibilities: assisted suicide and euthanasia. The only difference between the two is that, in euthanasia, it is the doctor who administers a lethal drug to end the life of a person who has voluntarily requested it. In assisted suicide, the doctor accompanies the process, but it is the person who takes the last step to administer the medication.
Jaramillo points out in an interview with France 24 that the adjective “dignified” in the face of death decisions is deeply subjective. “What is worthy is influenced by many factors, our beliefs, the disease we have, our situation,” explains the lawyer.
For her part, Dr. Graciela Jacob, a Palliative Medicine doctor and member of the Network of Care, Rights and Decisions at the End of Life in Argentina, adds something to think about: “No one can die with dignity if they have not had a decent life , a trajectory worthy of his illness, with care and support”.
The story of the “good death”
The modernization of medicine has shed a new light on the almost philosophical debate about who can die, how and for what reasons. However, there are antecedents of the practice of euthanasia in history: on the Italian island of Sardinia, for example, the myth of “s’agabbadóra”, “The Finisher”, a woman who went to the homes of rural towns to give the final push towards death to sick people who suffered and who wanted it.
In Argentina, Dr. Jacob recalls a similar example. “Ancestrally, there was a character called the “Despenador”, a nice name. The despenador in the northern provinces was someone who could be called when a person was sick, suffering and had not finished dying.”
“The stripper came to the house of the sufferer, made a very precise movement and broke his neck. He was someone who was trained since he was a child to be able to strip, take someone’s sorrows out,” continues Jacob.
But beyond the figures in ancestral cultures, the doctor assures that “there has always been euthanasia” or medically assisted deaths, even if they were practiced far from the public eye. Without going any further, the grandfather of the recently deceased Elizabeth II, George V, received euthanasia at the hands of his family doctor in 1936 after a long illness that had him bedridden and in a coma.
What debates exist around dignified death?
“Western societies hide the subject of death quite a bit. They don’t like to talk about deterioration or fragility,” laments Jacob. Thus, the transition to the end of life is made invisible and forgotten, and this forgetfulness is the first stone of the opposition that exists in many sectors towards the regularization of dignified death.
Of course, religion also plays a role: Christianity considers that only God can give and take life in due time and any human intervention in this regard is unthinkable, in a similar way to the argument surrounding the right to abortion. The weight of these beliefs is especially important in structurally religious societies, such as many in Latin America.
But beyond that, there are other beliefs that are not strictly religious that are the backbone of our way of thinking about health and medicine. For example, from bioethics it is argued that opening the doors to assisted death could imply that the people who suffer the most from social inequalities (of class, gender, race) would seek to take their own lives more frequently than those who have an easier time. his existence.
However, Camila Jaramillo speaks from the real experience of Colombia, the only country in the region where euthanasia is legal, to counter that argument. “The people who have access to euthanasia are the people who have access to the best health system, who live in the main cities, who have been diagnosed and who have received treatment,” she explains.
It also influences how medicine has always focused on saving lives: “If the doctor only understands death as a failure, he does everything possible to not let the person die,” recalls Jaramillo. Jacob confirms this: “We are all formed with the desire to do no harm, with the desire to save life at almost any cost.”
In addition, Jaramillo points to the “hierarchical” culture that exists in medicine, “where the doctor is the one who knows what is best for the patient and the patient only obeys.” In this sense, accepting patients’ decisions about their treatments and even about their own death is a challenge for the society that surrounds us, where it is not always understood that debating how we die is also a debate about how we want to live.
“As my mother used to say, who had the good fortune to die at 101 years of age, the ideal situation is to die alive,” concludes Jacob.
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