In a social context where conversations about choices and assistance at the end of life are becoming more frequent, we meet at REHUNO Health to explore a delicate and deeply human issue: euthanasia. In this space for reflection and dialogue, we want to open up to different perspectives and consider how we can generate a humanist view, or at least a “humanizing approach”, to this issue.

Euthanasia is a concept that involves complex ethical, moral, spiritual, and legal issues. It invites us to enter into a profound analysis of its implications and possibilities. We believe that before entering into this discussion, it is crucial to understand some other concepts related to the context in which euthanasia is discussed, such as good end-of-life care, advanced medical directives (AMD), and palliative care (PC).

Through this collective reflection, we hope to move towards a more holistic and humanizing approach to euthanasia in particular and to end-of-life care in general.

First of all, it is important to be aware of some concepts that are of great importance when it comes to accompaniment and decisions at the end of life:

Preliminary clarifications:

Euthanasia: This comes from Latin and Greek and means “sweet death” or “good death”. It refers to the deliberate provocation of the death of a person with an advanced or terminal illness, at the express request of the person and in a medical context.

Advance Medical Directives (AMD): – Orthostasis – are statements of intent made by a bioethically and legally competent person expressing their wishes about the medical care they wish to receive or not receive in situations where they are unable to communicate.

Palliative care (PC): is a comprehensive approach to care for individuals and families facing advanced or incurable illnesses. It does not delay or hasten the dying process but focuses on relieving physical pain and other symptoms of suffering and providing psychological and spiritual support for a good death.

Two possible views:

How to think about euthanasia from a “humanizing” perspective?

There are at least two points of view that seem to be in opposition to each other:

  1. the “freedom of choice” approach: some defend euthanasia as a humanizing option that allows people to choose the course of their own lives, including the possibility of ending their suffering.
  2. A second humanist view could be based on the concept of the “value of human life” as the highest value. They argue that the practice of euthanasia goes against the intrinsic value of human life and can undermine the protection of the most vulnerable, and therefore oppose the practice.
    These two “views” seem to contradict each other! How can we reflect on this apparent contradiction?

Integration and integral care
These apparent contradictions in euthanasia can only be resolved from a broader perspective that considers both positions within a framework of integral care at the end of life. This implies

First and foremost, recognizing the importance of palliative care and advance directives as essential components of end-of-life care.
Ensuring equitable access to resources and services that enable people to live their last moments with dignity and fulfillment, regardless of their financial situation.
Promote open and honest dialogue about euthanasia, ensuring that decisions are made in the context of holistic care and attention, and not because of avoidable physical pain and psychological suffering. Experience of palliative care in different parts of the world shows that many requests for euthanasia are modified when the person begins to receive comprehensive care and accompaniment. When they see that much of the physical pain and npsychological suffering that they wanted to eliminate can be alleviated and/or overcome and that they have the opportunity to live the last stages of their physical life with fullness and dignity.

Challenges and opportunities:
The path towards a humanizing view of euthanasia presents significant challenges and sometimes conflicting views. This “humanizing” dilemma can be resolved if we consider the different options within a broader perspective that includes both: “the holistic care of the person at the end of his or her physical life”.

Integrating everything into the same “framework” (moral, ethical, legal). A single regulation (law) that defines the rights to care in what we could call the “end of life” (physical) stage of a person. Not an unstructured regulation that speaks of palliative care on the one hand, DMA on the other, and euthanasia on the other. A view of “integral care for the non-end-of-life process” of a person, or “integral care for the good-dying”.

We therefore speak of a “revaluation” of this non-end-of-life stage and a revaluation of freedom of choice (euthanasia), but based on: equal opportunities for accompaniment and comprehensive care, clear and complete information about the existing options, and a health system that guarantees comprehensive care for physical pain, psychological suffering and the possibility of spiritual deepening at this significant stage of life for all people.

Conclusions

The ultimate goal is to develop an ethical, legal, social, and cultural approach that reflects the complexity and diversity of human experience at the end of life. This will require a collective commitment to overcome barriers and work towards a comprehensive system of care that both respects freedom of choice and promotes holistic care (physical, psychological, and spiritual) in the most difficult moments.

Euthanasia cannot be dealt with in a separate, isolated, and unstructured way. It must be addressed alongside palliative care and advance directives, and seen as part of a wider range of options to ensure comprehensive and humane care at the end of life.

Can a single integrated framework (ethical, legal, social, and cultural) be created that respects and reflects each of the above?

We believe that this is the challenge that needs to be taken forward….

This will help to “choose” euthanasia as an “option without end”, but from a wide range of options, information, and integral access to little-known therapies, treatments, and accompaniment that allow overcoming avoidable suffering.

It will not be easy, but we believe it is the closest option to a humanizing look at the issue of euthanasia and the other aspects that make up the “no end” of a person’s (physical) life.

It is an evolving conversation that invites reflection, dialogue, and action towards a future where freedom of choice is accompanied by comprehensive care (physical, psychological, and spiritual) that gives every human being equal opportunity to overcome avoidable suffering and to create the conditions for the best possible care at the end of life.

If you would like to take part in the “REHUNO Health Open Conversations”, please write to rehuno.salud@gmail.com

Next conversations

20 April. Humanist views on abortion.

18 May. Humanist views on health