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Wednesday, December 11, 2024

Some aspects of Dr Pleterski’s views on euthanasia

By: Dr Milan Krek

The hot political topic in recent days has been the proposal of a law on assistance in voluntary termination of life. Non-governmental organisations have submitted the proposal for parliamentary procedure, and a debate took place in the National Assembly a few days ago. The law was presented only in one segment, while all other aspects, which also belong to this issue based on long-term experiences in countries where euthanasia is legalised, were skilfully omitted by the proposers. They skilfully avoided discussing the abuse of euthanasia and its uncontrollable expansion, even to children aged 2–12 years.

Dr Andrej Pleterski emphasised at the outset that the law reflects the majority will of the citizens of Slovenia. However, when delving into these surveys, it becomes apparent that a panel survey was conducted with 515 individuals, which did not specifically inquire about the law, although from the speaker’s wording, it could be understood that he was referring to support for the law. The agency Mediana questioned people about general principles, which is different from how Dr Pleterski initially presented the data, suggesting that the question was whether people supported the law (Delo, May 13th, 2024). Furthermore, only 53.9 percent responded positively to this survey, with a low response rate, just slightly above half.

The Slovenian Public Opinion survey shows that euthanasia, not the law in 2022, was supported by over 73 percent, and that the percentage of support dropped to 63.5 percent in 2023, not specifically for the euthanasia law as Dr Pleterski expressed. The survey asked whether people found euthanasia acceptable, not about support for the euthanasia law. This naturally contradicts the claims of the proposer, Dr Igor Pribac, who asserted that support for the law was increasing. In reality, however, in 2023, according to public opinion research, the acceptability of euthanasia was ten percentage points lower than in 2022. It is essential to consider what people who were surveyed actually understood by euthanasia.

Falsehoods about the absence of abuses

The proposer then asserted at the outset that there is not a single case of abuse of euthanasia legislation worldwide, which again is not true. In the Netherlands, a case of euthanising a person who felt very tired at the age of 80 was addressed. The Supreme Court concluded that this action was not in line with the legislation in this area. In recent years, Dutch courts have dealt with three cases of suspected improperly performed euthanasia. The Belgian court also addressed euthanasia, carried out on the proposal of a son, for his mother who had a personality disorder and severe depression. The son was not even informed about the euthanasia procedure. He appealed to the European Court of Human Rights. The fact is straightforward: Dr Pleterski stated falsehoods – why he stated them in his justification for the law – I cannot explain.

I have read the explanation of the law in detail, and what particularly bothers me is the precise calculation of how much money is saved in the healthcare system through euthanasia and how much euthanasia costs per individual. As a physician who has fought for preserving life for several decades, it personally affects me deeply that the financial implications of allowing premature death or even assisting in it have been quantified. This speaks volumes about the individuals who proposed the law.

The Committee for Medical Ethics, composed of multidisciplinary experts (including physicians, lawyers, and others), was of the opinion that the legalisation of euthanasia would violate fundamental ethical principles in law and medicine. If euthanasia were to be implemented, it would quickly lead to involuntary euthanasia, diagnostic errors, and a weakening of pain relief efforts. It would disrupt the patient-doctor relationship, with the doctor losing their fundamental criterion for work, and legalisation would severely affect the sick and vulnerable. This is highlighted by the fact of how many people worldwide wish to prematurely end their lives. According to the committee, patients’ desires to die are cries for help and criticisms of the current situation. Therefore, I see one of the most important tasks of medicine as developing appropriate palliative care. The humanity and level of civilisation of society will increasingly be measured by what it is willing to do for the dying.

Dr Božidar Voljč, the president of the ethical commission, expressed himself on euthanasia as follows: “What the dying need is expert palliative care with effective pain relief and compassionate psychological and spiritual support. Without well-organised long-term care and a developed palliative field, which we cannot provide to the majority of the dying in Slovenia. Should end-of-life options (euthanasia) be the solution to existing deficiencies in the system?” he asked at the end of his speech.

The parliament’s decision regarding the further consideration of the law is also of great significance. There was a particularly impactful personal testimony from Member of Parliament Anže Logar, who demonstrated how euthanasia works through the example of his parents. If it were already in place, he could have lost them both, but instead, they were rehabilitated and continue to live their lives.

Parliament, with a large majority of 64 votes against, halted the process of adopting the law, which clearly reflects the stance of the people towards this proposal, as the members of parliament represent our voices in the National Assembly. This also contradicts the general support for the law as mentioned by the speaker in the introduction.

While the SDS party is against the adoption of such a law, the Gibanje Svoboda party suggests a referendum on this issue, which only reopens the debate on the justification and necessity of the proposed law.

A teenager can commit suicide without parental consent

The following excerpt is provided merely to inform people about what euthanasia actually entails and to highlight that euthanasia is not limited to the rare cases of seriously ill adults, as initially suggested by the speaker, Dr Pleterski. It should be noted that in the Netherlands, appropriate legislative procedures have been adopted to allow euthanasia for children aged 2 to 12 and for adolescents. Both the physician and the parents must be convinced beforehand that there is no other reasonable solution given the child’s situation. Parental consent is required for the termination of life. In Canada, there is also a rule that when a teenager’s desire for death outweighs the parents’ desire for their life, euthanasia follows the teenager’s wish rather than the parents’. In other words, if an anxious teenager wishes to undergo euthanasia without parental consent, parents have no power to prevent doctors from euthanising them. Dr Pleterski omitted all of this information. Only he knows why he did so.

Based on experiences from countries where euthanasia is already legalised, euthanasia has many dark sides, slips, and negative experiences. I cannot understand why scientists fail to mention the dark side of euthanasia upon its introduction, which would otherwise be fair from the proposers and necessary for understanding euthanasia itself.

Therefore, this time the parliament made an excellent move by halting the legalisation of euthanasia in Slovenia for the time being and prioritising life over premature death through euthanasia. Death, however, comes to everyone, even without euthanasia, so no one will escape it.

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