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Lettonie

  • March 2021 : Initiative on the Legalization of Euthanasia in Latvia

The issue of legalizing euthanasia in Latvia became a discussion topic in 2016, when the Latvian public donated money for an incurably ill person to fulfil his final wish of visiting Switzerland to undergo euthanasia. Even though the person died before his proposed trip to Switzerland, the issue of legalizing euthanasia became, thus, an important topic. An initiative called Par labu nāvi [For a Good Death] began in 2017, aiming for the legalization of euthanasia in Latvia. The initiative’s proponents explained that the allowing active euthanasia and medical-practitioner-assisted suicide would benefit to incurably ill people who could end their suffering voluntarily. Ten thousand signatures were needed to enable this initiative to be considered by the parliament (the Saeima) of the Republic of Latvia. This number was obtained within four years. The initiative was then submitted to the parliament for consideration.

On 10th March 2021, a parliamentary committee reviewed the joint submission by citizens of the Republic of Latvia regarding the legalization of euthanasia. Prior to making their decision, the committee heard six experts : two medical practitioners and four clergymen (representatives of the Evangelical Lutheran Church, the Roman Catholic Church, the Union of Baptist Churches and the Orthodox Church). One of the experts, the President of the Society of Anaesthesiologists and Reanimatologists of Latvia, spoke in favour of euthanasia. She admitted, however, that there was still a long way to go before a decision enabling the legalization of euthanasia could be made. This expert explained that extremely precisely regulated access to euthanasia was needed in Latvia, and that the first step could be that of assisted suicide – a process where patients themselves end their lives, avoiding medical practitioners having to resolve the ethically complicated dilemma of ending a person’s life or extending their suffering. The arguments of the other experts were against the legalization of euthanasia in Latvia, mostly because they viewed it as a risk of devaluation of the sanctity of life. The view of one of the committee members, a medical practitioner, was that the Latvian public has to first be prepared for the legalization of euthanasia. He conceded that, initially, a regulation could be introduced allowing medical practitioners to not revive a lethally ill person. Pointing out that passive euthanasia or the termination of medical treatment in hopeless situations should be distinguished from active euthanasia, the politician proposed the first step as the sorting out of passive euthanasia in legislation. He has prepared amendments to the Law on the Rights of Patients concerning passive euthanasia which will be submitted for consideration by parliamentary committees. In practice, this means the legal regulation of situations where a lethally ill patient asks for the maintenance of their life using artificial measures, for example artificial respiration, to be discontinued.

The parliamentary committee, emphasizing that everyone has the right to life, rejected the submission on the legalization of euthanasia : 12 of the 14 parliamentarians on the committee voted against legalization and two abstained. Even though the initiative to legalize euthanasia was rejected, discussion continued, revealing problems of a serious nature. (1) The palliative care system in Latvia is in a critical condition. The demand for state-funded palliative care, encompassing pain relief, psychological and spiritual assistance, far exceeds availability. The care of dying people is most often undertaken by relatives within the home. There is a long queue for state-funded seven-day palliative care, which means that palliative care is unavailable for people with limited financial means. (2) If euthanasia were to be legalized, the possibility of the slippery slope effect, or its malicious use by medical institutions or relatives to free themselves of seriously ill patients, would have to be eliminated. The euthanasia procedure would have to be rendered mistake-proof. This would cover, for example, situations where there was still a chance of a medical situation improving, or a legally competent patient changing their mind.

The discussion on euthanasia had already commenced before the Covid-19 pandemic. Draft legislation was prepared in collaboration with the Ministry of Health, medical practitioners, lawyers and specialists on medical ethics. In prescribed circumstances, this would allow medical practitioners to not reanimate a patient whose life would soon be taken by an illness, despite every effort by medical practitioners. Currently, medical practitioners do not have these sorts of rights in Latvia. During the pandemic, it has become even clearer that a serious discussion is required on the medical, ethical and legal grounds for euthanasia.

D 30 mars 2021    AAnita Stasulane

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