Euthanasia utopia or necessity Photo: www.que.esZoom
The practice of euthanasia in the history of mankind is ancient; there are many examples of euthanasia procedures from previous stages to the civilizations of ancient Greece and Rome in order to put an end to unbearable pain.
For twelve centuries, the transition to death was stripped of all drama; the sickroom became a place where everyone, even children, could enter freely. With the arrival of the Christian Middle Ages and until the Eighteenth century, the process of dying, before regulated by the family and religious communities, was gradually moving to the domain of the medical system, and death and the circumstances that generate it started to become a taboo topic.
From the Nineteenth century onward, great advances in the most effective diagnosis and treatment for disease, which made death to seem as an increasingly distant event. Technological advances made death look like a defeat, like an accident, like a failure of the health services and not as the natural and inherent condition to the development of all living beings.
That century marks the time of the rescue of the term euthanasia in medical literature —which comes etymologically from the Greek eu, well, and thanatos, death, and which literally means «good death» — in order to describe the duties of the physician to alleviate unbearable agony.
At present, this practice has achieved relative acceptance in Europe and part of North America, based on rigorous criteria explicitly described in the law. There are cases in Holland and Belgium; the Province of Quebec, Canada, and the states of Oregon, Washington, Montana, Vermont and California in the Union, with regulations governing «the good death. »
In South America, is worth highlighting the euthanasia practices in a country like Argentina, and the recent approval of the Death with Dignity Act.
The contradictions generated by the diversity of approaches and ethical, legal and medical foundations make this a very difficult issue to address. In a few years it has rekindled the controversy surrounding euthanasia; of talk of small family groups directly affected by the dilemma of death, it has become public debate and daily news. The interest responds to the introduction of other factors of reflection: the self-determination of patients and the new dimension that takes in the will or desire of the affected.
The main concern lies in the ethical possibility of giving a positive answer to whoever wants to die and asks for help to effect it, as part of the right that it assumes every person has over health and disease, and life and death.
The term is understood as any behavior by medical staff or people close to the patient, who by action or omission produce the acceleration of the natural process that leads to death, in order to avoid unbearable suffering after exhausting all possible treatments.
Addressing this debate involves taking into account the patient's will, manifested in full knowledge of its consequences, in full possession of his mental faculties and respect for the autonomy of those who suffer, to decide freely about their bodies and lives. It involves the approach from the medical ethics of health professionals, weighing as never before, the request of patients in this regard, clear information that his/her condition has passed and the real possibilities of healing or decrease in severe physical pain. And, it implies the Law as a mechanism to safeguard and protect the interests of all subjects involved, establishing the requirements that strictness must be met, ranging from the issue of will, reflective, repeatedly and explicitly embodied in a document called Living Wills or Living Will, to the participation of a multidisciplinary medical committee to validate the decision.
A Correct and Finished Regulation Rules will Limit the Margins for Arbitrariness and Error.
Heal, Relieve and Accompany
Cuba, a paradigm in providing medical services, maintains its position against euthanasia and defends the medical principles to heal, relieve and accompany the patient.
In Cuba, there is no cultural or legal support, or the accurate knowledge of the different variants in which euthanasia may occur, which allow scientists in the medical community and society to openly face debate on this option, despite the significant number of people suffering from malignant diseases and result in prolonged stages of physical and psychological suffering, with great impact on the family and society.
In our country, the fact of death is equipped with exaltation and drama from the Western culture, and influenced by established dogmas from the religious currents that brought the Spanish colonists to the people of America, when the fact of death and something fundamental: the awareness of our own mortality, should be assumed naturally.
Cuba does not define euthanasia behavior in criminal law as a special offense, but given its characteristics can be assimilated to murder or subsume it in the typical figure of assisted suicide, planned and sanctioned in Article 266 of the Cuban Penal Code. The main difference between the euthanasia procedure and the so-called «assisted suicide» is that in the latter whoever wants to die does not have to suffer some serious or terminal illness, just the simple desire to end his/her life.
For the controversy resulting from the analysis of conceptions about life and death, Cuban society has a sufficient level of maturity to debate the situation in which patients, families and medical professionals are found to not have guidelines accurate enough to meet certain extreme situations.
To put an end or not to the existence, in order to avoid suffering or artificial prolongation of life after exhausting all resources, will remain a sensitive issue that motivates heated controversies. Euthanasia is a choice that will continue to be thought about in every human being of modern civilization. For now, we can pose a question: Are we talking about a need or an utopia?
Mirell Llerena Medina – 3rd year student, degree in law from the University of Havana. Student assistant of Family Law.
Rosaly Hernandez Frómeta - Student 2nd. year student of the Bachelor of Medicine, the Victoria de Girón Faculty of Medicine. Student assistant of Ortholaryngology .
Translated by ESTI