Medical assistance in dying for palliative patients in different countries of the world: lessons on euthanasia legalization

Abstract

Background. The practice of countries in legalizing euthanasia is useful for other countries that have not yet allowed Medical Assistance in Dying (MAiD). Palliative patients in these countries have varying levels of access to medical care, including adequate analgesia. Medical care in many countries does not meet the needs of palliative patients, and systems of palliative and hospice care are often poorly developed. MAiD can be an alternative to the suffering of palliative patients at the end of life. Aim. Analysis of legal, social and financial aspects of euthanasia legalization in different countries of the world. Materials and Methods. The method of system analysis, comparative method and bibliosemantic method were used for the research. Results and Conclusions. The path to the legalization of euthanasia begins with a wide public debate. Important is the opinion of medical professionals, who are usually divided into two camps: those who deny the necessity and humanity of euthanasia, as well as those who advocate legalization to end the suffering of their patients, seeking to satisfy their persistent and conscious desire to exercise their "right to die". Countries take different paths and at different speeds to legalize euthanasia. The difference between the models of legalized euthanasia lies, first of all, in its permitted type (passive or active), distribution to different age categories of hopeless patients (in particular, to children), to incapacitated patients with cognitive disorders. Active euthanasia is allowed in such European countries as the Netherlands (since 2001), Belgium (since 2002), Luxembourg (since 2009), Spain (since 2010), Switzerland (since 2011). Since these years, there has been a change in the attitude towards medically assisted death of the European Court of Human Rights, which previously categorically regarded euthanasia as intentional murder. In all countries that have legalized euthanasia, an active discussion continues regarding the rules for its implementation. A common feature of countries that have already legalized euthanasia is the approval of the procedure by at least a third of medical professionals. Keywords: medically assisted suicide, suicide tourism, Quality of Death Index, suicide of critically ill palliative patients, right to life, right to die.