A strong controversy broke out in Colombia after the euthanasia scheduled for Martha Sepúlveda was canceled.
The woman was to be the first person to receive the procedure without having a terminal disease in this Latin American country.
As reported, the Interdisciplinary Scientific Committee for the Right to Die with Dignity “unanimously concluded to cancel the procedure” by determining that “the terminality criterion is not met as it had been considered in the first committee” that evaluated his case.
Sepúlveda suffers amyotrophic lateral sclerosis (ALS), a serious and incurable disease.
The decision has generated a strong discussion in Colombia, where an important part defends Sepúlveda’s right to “die with dignity” —and they insist on the need to better regulate this right— while others support the committee’s decision.
Colombia is the only country in Latin America where euthanasia is legal. Globally, only 7 countries have legalized this practice, including Spain, the Netherlands, Luxembourg and Canada.
How does the law work?
Despite the fact that euthanasia in Colombia was decriminalized in 1997, the first regulation was only created in 2015.
And in July of this year, the Ministry of Health and Social Protection of Colombia issued the resolution 971, through which the mechanism to guarantee the right to die with dignity in the country was again regulated.
Among the novelties of this new legislation is that euthanasia is no longer limited to people with terminal illnesses but also to others “advanced incurable” diseases.
Next, we answer seven key questions to understand how the procedure for approval or rejection of euthanasia works in Colombia.
1. Who can request euthanasia?
According to resolution 971, the request must be “voluntary, informed, unequivocal and persistent.”
The regulation says that the minimum requirements to express a request like this are: the presence of an end-of-life clinical condition; that is, an advanced incurable disease, a terminal illness, or dying; present suffering secondary to this; and be in a position to express the request directly.
2. What should a doctor do after receiving the request?
According to current Colombian legislation, the doctor who receives the request must “check that it is voluntary, informed and unequivocal“, and will have the obligation to inform the patient of their right to receive hospice care.
In addition, you must verify that the request has the minimum requirements. Afterwards, it will be in charge of registering the request from the moment it is expressed by the patient and reporting it within a maximum period of 24 hours.
The regulation states that all doctors are competent and responsible for receiving and processing requests for euthanasia.
And what, if there is an eventual conscientious objection, this must be expressed prior to the knowledge of the euthanasia request and can only be alleged by the doctor who has the duty to perform the euthanasia procedure.
3. What happens after the petition is reported?
Once the doctor has verified that the patient meets the minimum requirements to request euthanasia (and registered the request), the Committee Scientific Interdisciplinary for the Right to Die with Dignity, which is the body that evaluates each case.
The committee is made up of three members appointed by the Health Service Provider Institution (IPS): a doctor with the specialty of the pathology that the patient suffers, a attorney and a psychiatrist O psychologist clinical.
They cannot be conscientious objectors to the euthanasia procedure or caregivers of the patient.
The committee, then, must again verify the existence of the conditions to carry out the euthanasia procedure (the presence of a terminal or advanced incurable disease, among others) and “verify the inexistence of reasonable alternatives for specific treatment” for this disease.
These evaluations must be carried out in a maximum time of 10 days after the request has been received. If they are met, the committee will ask the patient if they reiterate their decision.
4. How is it approved or rejected?
According to resolution 971, “the quorum to deliberate and decide will be that of the all of its members “.
“The decisions will be adopted, preferably, by consensus. In the event that the committee does not reach an agreement on any of the issues, the majority will be admitted,” it is explained.
5. What happens if it is approved?
If the committee approves the procedure, it will be authorized and scheduled by the same patient in a maximum of 15 days after reiterating his decision to carry out euthanasia.
According to the president of the Colombian Medical Law Bar Association, Jesús Albrey González, “it is important that the patient persistently maintains the will.”
“On the other hand, the same resolution says that the patient can repent at any time and with this the procedure is canceled,” he added to BBC Mundo.
6. What if it is rejected?
According to resolution 971, the committee has the right to “suspend the processing of the application and the euthanasia procedure in case of detecting any irregularity and to inform the competent authorities of the possible commission of a fault or a crime, if it does so. if there is place “.
If their request is rejected, the patient can request the creation of a second committee made up of different people to have your case reviewed once more.
How did Colombia get here?
The history of the legalization of euthanasia in Colombia begins in 1997, when the Constitutional Court declared the crime of “mercy killing” unconstitutional and exempted doctors from criminal responsibility if it was a terminally ill patient under intense pain or suffering who had requested death freely and in full use of their powers.
But at that time the Constitutional Court also called for strict legal regulations to be established for protect the right to life, leaving the matter in legal limbo for years.
The issue was taken up again almost two decades later, in 2014, when a new court ruling gave the Ministry of Health 30 days to regulate the right to a dignified death.
This is how 2015 the resolution 1216 with which the procedure to enforce the right to die with dignity begins to be developed.
In this resolution, for example, the creation of the Interdisciplinary Scientific Committee for the Right to Die with Dignity, which evaluates the cases, was established.
This year, another resolution was created, 971, which, as explained above, incorporates those who suffer from “incurable diseases.”
On the other hand, last July the Constitutional Court of the country extended the right to a dignified death to those who suffer “intense physical or psychological suffering” due to an injury or incurable illness.
But, as lawyer Jesús Albrey González explains, to this day there is no statutory law that regulates the fundamental right to die with dignity through euthanasia in Colombia.
“For the same reason, there are many legal loopholes, as in the case of Martha Sepúlveda. Is it possible that a procedure like this can be canceled just one day before? That, for example, is not regulated. And it is necessary to discuss it, “he says.
“Dying with dignity in Colombia is today a fundamental right. And that gives it a rank of constitutional protection and priority. So you have to urgently legislate on this issue, “he adds.
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