Tuesday, October 19

Euthanasia: who can request it, how and with what controls



The euthanasia law, which will be definitively approved by Congress this Thursday, will enter into force three months after being published in the Official State Gazette and it will include medical aid to die as a new benefit in the National Health System, with clear rules on who can request it, how and with what controls.

If the patient meets the requirements set by law and there are no incidents, they can be euthanized about five weeks after applying, after a process in which you will be informed of the different alternatives and available palliative care.

The law also regulates the possibility of ask for help dying in an advance directive document, known as a living will, which will be used when the person cannot make a request autonomously and consciously.

Who can request it

The first requirement is be of legal age and suffer “a serious and incurable disease” or a “serious, chronic and incapacitating condition” that affects autonomy and generates “constant and intolerable physical or psychological suffering”.

You must have Spanish nationality, legal residence in Spain or registration certificate that proves a time of stay in Spanish territory of more than twelve months.

In the event that the patient is not in full use of his or her powers or is unable to give his free, voluntary and conscious consent, he must have previously signed a prior instructions document, a living will, advance directives or legally recognized equivalent documents.

Procedure

The patient must make two requests voluntarily and in writing, leaving a separation of at least fifteen days between the two, although the doctor can shorten this period if he believes that there is an “imminent” risk of “loss of ability” of the patient to grant informed consent.

The applicant for the benefit of dying aid may revoke his application at any time or request its postponement.

Once the first request has been received, the responsible doctor will carry out a “deliberative process” with the patient regarding their diagnosis, therapeutic possibilities and expected results, as well as possible palliative care, an analysis that will be repeated after the second request.

Then the person will be asked again if they want to withdraw or continue. If the request is maintained, the responsible physician must consult the case with a “consulting physician”, who will have a period of ten days to verify compliance with the conditions.

Guarantee and evaluation commission

In each autonomous community, a ‘Guarantee and Evaluation Commission’ composed of medical, nursing and legal staff and ultimately responsible for authorizing each euthanasia process.

After being informed by the doctor of a request, the president of the commission will designate two members who will have seven days to verify that the requirements provided for in the law are met.

The unfavorable resolutions of the Commission may be appealed before the contentious-administrative jurisdiction.

Performing euthanasia

The patient has the right to choose how you want to receive help to die: Medical personnel to directly administer a substance to you, or to prescribe or provide the substance to you, so that it can be “self-administered” to cause your own death.

In the first case, the law establishes that the healthcare team will assist the patient until the moment of death. In the second, that “he will maintain the due task of observing and supporting him until the moment of his death.”

The process may be carried out in health centers -public, private or subsidized- or at the home of the patient.

Once the euthanasia has been carried out, the responsible doctor will have to send all the documentation of the case to the Guarantee and Evaluation Commission.

According to this law, death as a result of the provision of aid to die will be considered a natural death by law.

Performance guarantee

The provision of aid to die will be included in the common portfolio of services of the National Health System and it will be publicly funded. The regional health services must guarantee the provision.

The law recognizes health professionals the right to conscientious objection, which they must state in advance and in writing.

The health administrations will create a registry of objectors, subject to strict confidentiality, to guarantee the adequate management of the benefit.


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