Updated Jan. 19, 2024 at 12:25 p.m.
Luca Zaia, the president of Italian region of Veneto, is hardly a radical progressive. Yet the longtime center-right party leader of the northern region has become the leading advocate for addressing Italy’s draconian laws forbidding assisted suicide.
With the weight of the nearby Vatican ever present, politicians around the country, including right-wing Prime Minister Giorgia Meloni, have lambasted the attempt to pass a law in Veneto to address thorny “right-to-die” issue and give new rights to the terminally ill.
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“I am sorry that someone gave it a wrong reading, that the law discussed in Veneto somehow instituted “the end of life,”" Zaia said earlier this week, according to the Italian edition of Vanity Fair. “It did not institute anything, but only established the ways and times of responses to the sick, and the ways in which the healthcare companies are involved.”
Zaia’s long-term interest in trying to establish a law in Italy about euthanasia was given a new boost in November after the nation was transfixed by a video published by the Rome daily La Repubblica of Sibilla Barbieri. The well-known Italian actress and director, who had battled cancer for 10 years, had been forced to go to Switzerland to carry out assisted suicide to end her suffering.
“I can afford to arrange a trip to Switzerland where my rights will be guaranteed,” she tells the camera. “But what about all those who cannot? Condemned to not choose how to live until the very end. I ask you to stand up against this injustice so that the parliament will finally debate and vote on a fair law. When you’ll see this video I will no longer be here because I have chosen to live freely until the end. Until the very end, I chose to disobey.”
Such dramatic cases around the world highlight the public debate around right to die, particularly in the post-COVID era – maybe as a result of the coronavirus pandemic and its numerous victims, which forced us to face our own mortality head on.
While euthanasia and assisted suicide are legal in just a handful of countries around the world, more are allowing the practice in certain conditions, or for specific cases.
Switzerland tried and approved the "suicide capsule"
In January 2022, the announcement that a “suicide capsule” device was to be commercialized in Switzerland, not surprisingly, caused quite a stir. The machine called Sarcophagus consisted of a 3D-printed pod mounted on a stand, which released nitrogen and gradually reduced the oxygen level from 21% to 1%, causing the person inside to lose consciousness without pain or a sense of panic, and then die of hypoxia and hypocapnia (oxygen and carbon dioxide deprivation).
While active euthanasia is illegal in Switzerland, assisted suicide is allowed under certain conditions and under the supervision of a physician, who has first to review the patient’s capacity for discernment — a condition that Sarcophagus aimed to eliminate. “We want to remove any kind of psychiatric review from the process and allow the individual to control the method themselves,” Australian doctor Philip Nitschke, the machine’s creator, told news platform SwissInfo. Some argued that this is against the country’s medical ethical rules while others expressed concerns about safety.
But Nitschke said he found the solution: an online AI-based test, which would have given a code to the patient to use the device if he passed.
New Zealand offers choice for terminal patients
New Zealand is one of the latest countries which legalized euthanasia, following a referendum in 2020 with nearly 65% of voters supporting the End of Life Choice Act to become law. The legislation, which came into force in November 2021, includes conditions such as suffering from a terminal illness likely to end the person’s life within six months and being aged 18 or over, with certain steps to go through to ensure a person is eligible. The government also created a committee of three experts as a safeguard, to review reports of those undergoing the procedure.
The procedures are far from widespread and some are still hesitant to legalize them.
“New Zealand became a kinder, more compassionate and humane society for allowing people who are struggling and suffering in those last few days with their terminal illness choice and compassion on how and when they go,” said Brooke van Velden, the deputy leader of the ACT New Zealand party, which promoted the End of Life Choice Act.
Medical aid in dying for Alzheimer’s and dementia
In January 2022, Austria’s parliament approved legislation to legalize assisted suicide for chronically or terminally ill people. The move followed a decision from a court that stipulated that the country’s criminal code ban of assisted suicide was unconstitutional and violated the individual’s right to self-determination.
In Quebec, Canada, a government commission has released a report at the beginning of December 2021 that greenlights extending medical aid in dying for people suffering from a serious and incurable illness leading to incapacity, such as Alzheimer’s disease and dementia. So far, Quebec’s 2014 “End-of-life care law” had only allowed people who were deemed apt to give consent to make a request for the procedure, excluding those who suffered from neurocognitive disorders.
Peru pave the way
In Peru euthanasia is punishable by up to three years in prison. In February 2021, Ana Estrada became the first person to be granted the right to die in the South American country, after a judge decriminalized the practice specifically for her.
The 44-year-old woman had been diagnosed at 12 with polymyositis, an incurable and degenerative disease that weakend her muscles and forced her to stay in bed most of the time. Although the judge refused Estrada’s request to order the Health Ministry to prepare a directive for other similar cases, some hoped the ruling would constitute a step forward the legalization of euthanasia in the near future, but to this day it still hasn’t moved from its position against it.
Battles over wording of laws
While euthanasia and assisted suicide seem to gain ground in several countries, the procedures are far from widespread and some are still hesitant to legaliza them.
In January 2021, Portugal’s parliament voted to legalize euthanasia, setting the country on its way to becoming the seventh in the world to allow the procedure. But Portuguese President Marcelo Rebelo de Sousa vetoed the bill for the second time after already refusing to sign a first draft. The leader criticized the wording of the proposed law, saying it was too imprecise when it came to the justification of assisted suicide.
The legislation has been finally approved with an absolute majority and assisted suicide is now decriminalized in cases where it concerns people of legal age, capable of consent, suffering from serious and incurable illnesses or injuries and subject to intolerable suffering. The law also stipulates that a minimum period of two months will pass from the time the request for assisted suicide is made to its implementation, and a follow-up on the person’s psychological condition is mandatory.
Across Africa, the debate has barely been opened. Suzanne Walter, a South African palliative care specialist, and her patient Diethelm Harck, who had both been diagnosed with terminal diseases, pleaded their case before the Pretoria High Court in early 2021, with Harck saying” “my biggest fear is that when my love of life reaches the stage of fearing life, I will not be able to die.”
But an August 2022 decision rejected any form of euthanasia, saying the focus instead should be on making palliative care accessible to the population. “We believe,” doctor Emmanuel Luyirika said “that if palliative cares are easily accessible therefore the needs of the patient are met, then euthanasia will no longer be discussed.” To this day, the right to die is not legal in any part of Africa. The battle still stands.