Euthanasia and PAS Euthanasia an ambigous concept Analytical usage - PDF document

11/23/17 Introduction Euthanasia and PAS • Euthanasia – an ambigous concept • Analytical usage vs. normative usage WMA European Region Meeting • Ethics – Human Rights – (National) Legal on End-of Life Questions Systems • Common Law Countries – Civil (Roman) Law 16 November 2017 Countries • All legal systems differ – Is there one great Prof. Dr. Dr. h.c. Volker Lipp divide? 16.11.2017 Prof. Dr. Dr. h.c. Volker Lipp 2 Definitions Definitions • Assisted Suicide – intentionally killing oneself • (rep.) Euthanasia – intentionally killing with the assistance of another person another person in order to relieve this person‘s suffering (voluntary, non-voluntary, • PAS – suicide with assistance of a physician involuntary) • Euthanasia – intentionally killing another • „Letting die“ – limitating, terminating, person in order to relieve this person‘s withholding life-sustaining treatment because suffering (voluntary, non-voluntary, it is futile or according to the patient‘s will involuntary) (sometimes also called „passive euthanasia“) 16.11.2017 Prof. Dr. Dr. h.c. Volker Lipp 3 16.11.2017 Prof. Dr. Dr. h.c. Volker Lipp 4 Overlapping? Human Rights • (Physician-assisted) suicide • European Convention on Human Rights (1950) • Voluntary euthanasia • European Court of Human Rights • Terminating or withholding life-sustaining – no consensus amoung Council of Europe treatment according to the patient‘s will member states – wide margin of appreciation for member states – several complaints declared inadmissible 16.11.2017 Prof. Dr. Dr. h.c. Volker Lipp 5 16.11.2017 Prof. Dr. Dr. h.c. Volker Lipp 6 1

11/23/17 Human Rights Human Rights • European Court of Human Rights on (P)AS • European Court of Human Rights on (P)AS - violation of ECHR if state does not examine – no violation of ECHR if state prohibits the merits of a claim for access to lethal drug assisting another person‘s suicide in order to commit suicide („Diane Pretty“, 29.4.2002) („Koch“, 19.7.2012) - overruling of „Haas“ by Chamber but – no violation of ECHR if state does not judgment of 14.5.2013 did not become final provide access to lethal drug without („Gross“, Grand Chamber, 30.9.2014) prescription in order to commit suicide • Note: German Federal Administrative Court (2.3.2017) („Haas“, 20.1.2011) – access to lethal drug in order to commit suicide granted by German constitution in extreme cases 16.11.2017 Prof. Dr. Dr. h.c. Volker Lipp 7 16.11.2017 Prof. Dr. Dr. h.c. Volker Lipp 8 Human Rights “Letting die” • European Court of Human Rights • Limitating, terminating, withholding life- sustaining treatment is widely accepted in – no violation of ECHR if state allows principle , but conditions vary, e.g. withdrawal of life-sustaining treatment (5.6.2015 „Lambert“) • Limited to patients who are terminally ill? – So far no decision on euthanasia apart from • Also for patients incapable to decide? And „Lamb“ (23.6.2015, complaint against UK who is to decide for them? ban on voluntary euthanasia inadmissible) • Significance of advance directives 16.11.2017 Prof. Dr. Dr. h.c. Volker Lipp 9 16.11.2017 Prof. Dr. Dr. h.c. Volker Lipp 10 Euthanasia Physician-Assisted Suicide • Group 1 (e.g. Austria): Ban on all forms of • Most European countries ban all forms of assisted suicide (and euthanasia) euthanasia by criminal law • Group 2 (e.g. D): Euthanasia and some forms of • NL, B and L have legalized voluntary assisted suicide including PAS are banned euthanasia by a physician for adults, NL and B • Group 3 (e.g. CH): Euthanasia is banned but also for minors (conditions differ) assisted suicide including PAS is legal under • The Netherlands also allow (non-voluntary) certain conditions euthanasia of newborn babies that are • Group 4 (e.g. NL, B, L): PAS is legal under terminally ill (under conditions laid down in conditions similar to those for voluntary the „Groningen protocol“) euthanasia 16.11.2017 Prof. Dr. Dr. h.c. Volker Lipp 11 16.11.2017 Prof. Dr. Dr. h.c. Volker Lipp 12 2

11/23/17 Access to lethal drug • Access to lethal drug in order to commit suicide • Access regulated - prescription by physician Thank you for listening! → PAS - grant of access by regulating authority → case law of Europan Court of Human Rights and of German Federal Administrative Court 16.11.2017 Prof. Dr. Dr. h.c. Volker Lipp 13 16.11.2017 Prof. Dr. Dr. h.c. Volker Lipp 14 3