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TODAY: Spain’s euthanasia law comes into effect

A law legalising euthanasia and assisted suicide came into effect in Spain Friday, making the country one of a few to allow terminally-ill or gravely-injured patients to end their own suffering.

Published: 25 June 2021 14:14 CEST

TODAY: Spain's euthanasia law comes into effect

A man holds a placard reading "To choose to die without suffering" during a demonstration in support of the law legalising euthanasia Photo: JAVIER SORIANO / AFP

The legislation, which was passed by parliament in March, “responds to the existing social demand on the matter” and contains “safeguards” on the implementation of euthanasia, the health ministry said in a statement

Spain is the fourth European nation to decriminalize assisted suicide after the Netherlands, Belgium and Luxembourg.

The law was drafted following public pressure generated by several high-profile cases, notably that of Ramon Sampedro whose plight was immortalized in the Oscar-winning 2004 film “The Sea Inside”.

It permits euthanasia in which medical staff intentionally end a life to relieve suffering, and assisted suicide in which it is the patient who carries out the procedure.

Anyone with a “serious or incurable illness” or a “chronic or incapacitating” condition can now request help dying to avoid “intolerable suffering”.

The patient must be a Spanish national or a legal resident and “fully aware and conscious” when they make the request, which has to be submitted twice in writing, 15 days apart.

A doctor can reject the request if the requirements have not been met. It must be approved by a second medic and by an evaluation body.

Any medic can withdraw on grounds of “conscience” from taking part in the procedure that will be available via Spain’s national health service.

But the legislation has drawn stark opposition from the Catholic Church and from Spain’s political right, with the main opposition Popular Party filing an appeal against the law on Thursday at the Constitutional Court.

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A person in a medical coat holds hands with another

Euthanasia and assisted suicide might be spoken of in the same breath, but they are quite different. Here's what you need to know. Photo by Matheus Ferrero on Unsplash

The terms assisted suicide, assisted dying and euthanasia are often used interchangeably – even by media and politicians covering the matter.

There are however some key differences, both in terms of the legal situation and the practice itself.

Assisted suicide is where a medical professional, usually a doctor but sometimes a pharmacist or other specialist, provides some form of medication to assist a patient as they commit suicide.

EXPLAINED: How foreigners can access assisted suicide in Switzerland

Crucially, it is the patient who takes the final step, i.e. by taking a medication or by pressing a switch through which the medication is administered.

Euthanasia on the other hand is where the medication which ends someone’s life is administered by a doctor or medical professional.

Euthanasia is sometimes known as voluntary euthanasia, which references the fact that the patient volunteers for the process by providing consent.

Other forms of medical intervention which lead to death – for instance turning off life support for someone who has been in a long-term coma – do not fit within the definition of voluntary euthanasia.

The term ‘assisted dying’ is used as a grouping term to refer to both assisted suicide and euthanasia, although media sources – particularly in the United Kingdom – often use assisted dying when referring primarily to assisted suicide.

What are the rules for assisted suicide and euthanasia in Switzerland?

The law in Switzerland recognises the distinction between assisted suicide and euthanasia.

Euthanasia is not permitted under law in Switzerland, while assisted suicide is allowed for both locals and foreigners.

While article 115 of the Swiss penal code prohibits assisted suicide for “self-serving reasons” and article 114 prohibits “causing the death” of a person for “commendable motives, and in particular out of compassion for the victim”, assisted suicide for non-selfish reasons is not specifically prohibited as long as certain conditions are met.

The Swiss supreme court has ruled the following: people must commit suicide by their own hand, for example, by taking medication themselves. A doctor cannot administer a lethal injection without being liable for criminal prosecution.

People must also be aware of actions they are undertaking and have given due consideration to their situation. In addition, they be consistently sure they wish to die, and, of course, not be under the influence of another person, or group of persons.

READ MORE: What you need to know about assisted suicide in Switzerland

Several other jurisdictions across Europe and the globe also make a legal distinction between the two, although euthanasia is legal in some countries including the Netherlands, Belgium, Luxembourg and Columbia.

What is the medical procedure involved?

Most Swiss associations request that patients drink sodium pentobarbital, a sedative that in strong enough doses causes the heart muscle to stop beating.

Since the substance is alkaline, it burns a bit when swallowed.

A professional prepares the needle, but it is up to the patient to open the valve that allows the short-acting barbiturate to mix with a saline solution and begin flowing into their vein.

A video is shot of the patient stating their name, date of birth and that they understand what they are about to do. The camera keeps rolling as they open the valve and the footage is used as evidence that they willingly took their own life.

It usually takes about 20 to 30 seconds for the patient to fall asleep.

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