Thursday, 6 May 2010

Addendum on the Right to Die Comfortably

I recently reported on an important clarification of Swedish policy regarding patients who want to terminate life-supporting treatment and also receive effective palliation, i.e. an unequivocal affirmation of such a right. Today, Dagens Nyheter, my country's leading newspaper, reports that the woman who had appealed to the National Board of Health and Welfare for this clarification had her respiratory treatment terminated after having been sedated and, as an effect, passed away on Wednesday – all on her own request. Before that, she sent a text-message to Dagens Nyheter expressing her satisfaction with the decision of the NBHW.

The comments so far have been humble and restrained, and the the Ethics Delegation of the Swedish Society of Medicine took the opportunity to sensibly distance itself from the unfruitful lingo of "active" and "passive" euthanasia, stating that terminating a treatment has nothing to do with killing people in the legal sense.

However, Dagens Nyheter itself gets it wrong in its comment when saying that this is a radical policy shift. It is not. As described in my earlier blog on this, respecting patient's wishes not to undergo life-supporting treatment in combination with affirming their right to effective palliation has been accepted practice for about a decade until a recent legal case (as yet to be decided on). The comment also gets it wrong when making analogies to a case some years back, when a paralysed man requested physician-assisted suicide, was declined this and then ended his own life at the well-known suicide clinic in Switzerland. The crucial difference is that this man was not undergoing any sort of life-supporting treatment, and the clarified policy is thus not applicable to that case. Until anything else is decided, the received custom of viewing the assistance to suicide as incompatible with acceptable medical practice will prevail.

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