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Europe: When Dying Seems Better Than Living

The 44-country Council of Europe human rights body has just issued a study of laws and practices governing euthanasia and assisted suicide across Western and Eastern Europe. The study will help the council's Committee of Ministers decide what position to take on one of Europe's most sensitive issues. Council bioethics specialist Calum MacKellar spoke to RFE/RL about the history and status of the euthanasia debate among council member nations.

Prague, 22 January 2003 (RFE/RL) -- If you should want to start an argument in Europe, one good way would be to take a stand on euthanasia -- meaning, by its Greek roots, "a happy or painless death." One contentious issue is whether it should ever be permitted. Another is this: What exactly constitutes euthanasia?

According to a 1976 council resolution, "What dying patients most want is to die in peace and dignity." Moreover, the council says the "prolongation of life should not in itself constitute the exclusive aim of medical practice."

But, as Council of Europe bioethics specialist Calum MacKellar pointed out, the council's Parliamentary Assembly in 1999 adopted Recommendation 1418, which firmly opposes mercy killings in any form. MacKellar cited two controlling passages from the recommendation: "Recognizing [a] terminally ill or dying person's wish to die never constitutes any legal claim to die at the hand of another person," and, "Recognizing [a] terminally ill or dying person's wish to die cannot, of itself, constitute a justification to carry out actions intended to bring about death."

The council took up questions about euthanasia, assisted suicide, palliative care, and the right to die because of legal developments in Belgium and the Netherlands. Belgium adopted laws permitting and setting standards for euthanasia. The Netherlands retains its laws prohibiting euthanasia but provides that physicians who engage in the practice may not be prosecuted if they abide by specified safeguards and procedures.

The council's Committee of Ministers has been considering its response since the Parliamentary Assembly adopted Recommendation 1418 three years ago. The council directed its bioethics division to undertake a study of laws and practices governing euthanasia and assisted suicide across Western and Eastern Europe. The division has just issued its results.

European states organized the Council of Europe in 1949 to promote democracy and human rights across the entire European continent. The council since has grown to encompass 44 members, nearly all the states of Europe, both Western and Eastern.

The Parliamentary Assembly comprises representatives elected by member states' national parliaments. MacKellar said the assembly "can only give recommendations, and this is what you have with respect to euthanasia in front of you. There is another body which has a lot more, basically, a lot more authority. And that is the Committee of Ministers of the Council of Europe, and it is the Committee of Foreign Ministers of the Council of Europe."

The study commissioned by the Committee of Ministers finds that Belgium stands alone in Europe in explicitly permitting euthanasia. In addition to the Netherlands' hands-off approach, there is a tacit acceptance of assisted suicide in countries like Estonia and Switzerland, where a terminally ill British man died on 20 January after traveling to an "assisted-suicide" clinic in Zurich. Swiss law does not consider it illegal to help someone commit suicide.

A number of additional countries accept, in practice, the administration of substances to relieve suffering whose side effects might hasten death.

Definitions of various degrees of easing the death of the terminally ill differ from country to country. Albania, for instance, uses "euthanasia" as an umbrella term covering any form of intervention to provide merciful death.

MacKellar personally distinguishes between euthanasia and assisted suicide as follows: Euthanasia occurs when a physician places a death-dealing pill in the patient's mouth; assisted suicide when the physician places the pill in the patient's hand and the patient does the rest.

MacKellar said neither Recommendation 1418 nor the bioethics-division study will determine the stand the Committee of Ministers eventually will take on the issue. However, he said the ministers are likely to determine their position sometime this year.