Euthanasia: between the right and the offense

Размещено на http://www.allbest.ru/

Dnipropetrovsk State University of Internal Affairs, Dnipro, Ukraine

Euthanasia: between the right and the offense

Borys Lohvynenko

Dr. of Law, Professor

Борис Логвиненко

Евтаназія: між правом та правопорушенням

Анотація

ban euthanasia person right

Проблема легалізації або продовження заборони евтаназії на національному рівні продовжує викликати широкий суспільний резонанс. Вказана проблема носить комплексний характер, адже стосується не лише медичних питань, а й правових та біоетичних. Евтаназія значно збільшує ризики зловживання цим правом щодо пацієнтів, які бажають реалізувати відповідну процедури гідного та осмисленого припинення життя для припинення страждань. Метою статті є розкриття дуалістичної сутності евтаназії - як права особи на гідну смерть, та як кримінально караного правопорушення.

У статті зроблено акцент на сучасних наукових поглядах на евтаназію, що охоплюють три аспекти: 1) негативний - підтримка діючої заборони евтаназії; 2) позитивний - необхідність створення правових інструментів для реалізації права на добровільне припинення власного життя; 3) альтернативний - прихильники якого розглядають можливість заміни евтаназії іншими, більш гуманними з точки зору біоетики процедурами (паліативна допомога, добровільна відмова від лікування тощо). Звернуто увагу на те, що право вільно розпоряджатися власним життям має місце в національному законодавстві. Так, відмова пацієнта від медичного втручання, або від лікування може мати наслідком наближення моменту смерті.

Наголошено на поширенні міжнародної практики подальшої лібералізації та розширення кола держав, що підтримують процедури евтаназії. Акцентовано увагу на тому, що різноманітність процедур і форм евтаназії не дозволяє чітко визначити, яка з них є найбільш прийнятною у правовому аспекті. Водночас, всі такі процедури і форми передбачають одне - право невиліковно хворої або страждаючої від хронічної хвороби людини самостійно визначити, як і коли померти. Зроблено висновок про те, що евтаназія є власним вибором людини і це найголовніше в її усвідомленні, як складової права на життя. Підтримано позицію щодо можливості її легалізації в Україні у майбутньому.

Ключові слова: евтаназія, умисне вбивство, право на життя, право на гідну смерть, вибір.

Abstract

The problem of legalization or continuation of the ban on euthanasia at the national level continues to cause wide public resonance. This problem is complex in nature, because it concerns not only medical issues, but also legal and bioethical issues. Euthanasia significantly increases the risks of abuse of this right for patients who wish to implement an appropriate dignified and meaningful end-of-life procedure to end suffering.

The purpose of the article is to reveal the dualistic essence of euthanasia - as a person's right to a dignified death, and as a criminal offense. The article focuses on modern scientific views on euthanasia, covering three aspects: 1) negative - support for the current ban on euthanasia; 2) positive - the need to create legal instruments to implement the right to voluntarily end one's life; 3) alternative - supporters of which consider the possibility of replacing euthanasia with other procedures that are more humane from the point of view of bioethics (palliative care, voluntary refusal of treatment, etc.).

Attention was drawn to the fact that the right to freely dispose of one's own life is enshrined in national legislation. Yes, the patient's refusal of medical intervention or treatment may result in the approaching moment of death. The spread of the international practice of further liberalization and expansion of the circle of states that support euthanasia procedures are emphasized.

Attention is focused on the fact that the variety of procedures and forms of euthanasia does not allow to clearly determine which of them is the most acceptable from a legal point of view. At the same time, all such procedures and forms provide for one thing - the right of a terminally ill or chronically ill person to independently determine how and when to die. It was concluded that euthanasia is a person's own choice and this is the most important thing in his awareness as a component of the right to life. The position regarding the possibility of its legalization in Ukraine in the future is supported.

Keywords: euthanasia, intentional killing, right to life, right to a dignified death, choice.

Relevance of the study

Human rights can be considered as a dynamic category, because the content and scope of such rights is constantly changing, adapting to the realities of today and the civilizational development of society. What was considered unacceptable or forbidden recently is now in the realm of lawful behavior. The legalization of soft drugs, prostitution, euthanasia, surrogate motherhood, crypto-currency operations, pornographic products, same-sex relationships, reassignment and many other things are the norm of proper behavior for the population of some states and an inviolable taboo for other communities.

Euthanasia has a special place in the list above. If we consider the right to life as a complex category, then it arises from the moment of birth and ceases from the moment of death. In turn, the full legal capacity of a person involves his ability to exercise rights and fulfill obligations through his actions. Combining these two points, one can think about the fact that a person's right to life also includes the ability to dispose of it at his own discretion. But if this is considered impossible at birth, then after reaching legal age, a natural person can freely manage his life, choose a profession, form his own worldview, political and other beliefs, etc. In particular, this may include the right to voluntarily end one's own life, in cases provided for by law. The problem of the ethics of euthanasia is hotly debated among philosophers, scientists, doctors, politicians, lawyers, intellectuals and ordinary citizens all over the world. Some countries have legalized euthanasia, others have banned it as an inhuman and illegal practice.

Recent publications review

Issues related to euthanasia in the context of legal sciences were studied by: N. Borysevich, M. Gromovchuk, O. Dzyubenko, A. Zaporozhchenko, V. Zakharov, B. Ostrovska, O. Terzi, I. Shapovalova and many other specialists. At the same time, a thorough study of the bioethical and legal issues of the introduction of euthanasia or the continuation of its ban in Ukraine is directly related to the adaptation of national legislation to the standards of the European Union. On the other hand, the transformation of social values does not allow us to be guided by outdated ideas about law and offenses. This is what determines the relevance of the presented work.

The article's objective is a scientific analysis of euthanasia as a person's right or an offense related to it, with the justification of possible perspectives of the attitude to this procedure in Ukraine.

Discussion

In general, euthanasia comes from the German concept "Euthanasie" (from the Greek «eu» - «good» and «thanatos» - «death») and includes two components: 1) quiet, painless death; 2) euthanizing a terminally ill patient in order to end his suffering. Accordingly, a distinction is made between passive and active euthanasia. Passive euthanasia consists in the deliberate termination of treatment of a sick person so that his suffering ends as soon as possible. Active euthanasia is the intentional administration of drugs or the use of other necessary actions that allow a quick and painless end to a person's life. In the case of active euthanasia, appropriate drugs can be administered either by a medical worker or given by him to the patient, who will administer them himself [1, p. 126].

At the legislative level, euthanasia is prohibited in Ukraine. This is mainly due to the inalienability of the right to life, guaranteed by Article 27 of the Constitution of Ukraine [2]. Also, parts 2, 4 of Article 281 "Right to Life" of the Civil Code of Ukraine stipulates that a natural person cannot be deprived of life, as well as the prohibition of satisfying a natural person's request to end his life [3].

Part 7 of Article 52 "Determining the irreversible death of a person and stopping active measures to maintain the patient's life" of the Fundamentals of the Health Care Legislation of Ukraine, which provides for the prohibition of euthanasia by medical workers, i.e. the intentional acceleration of death or the killing of an incurably ill person for the purpose of ending his suffering [4, p. 181].

Turning to scientific approaches to the problem of euthanasia, let' s take into account the opinion of I. Haydachuk, who points out that supporters of "accelerating the death" of patients argue that a person has the right to life, and therefore the right to dispose of it. It is impossible to imagine that a person is free on legal grounds to dispose of his property, but not his life. Opponents of euthanasia point out that life is good and it remains good even when it becomes mainly continuous suffering [5, p. 227].

V. Zakharov and I. Shapovalova draw attention to the fact that the use of euthanasia methods is unacceptable in modern life. According to the researchers, human life should be preserved in all cases until the natural end, because medical science and practice do not guarantee the absence of diagnostic errors. The legalization of euthanasia can harm medical activity and contribute to abuse, and therefore will increase the distrust of the population in the quality of medical care and the health care system as a whole [6, p. 188].

The director of the British alliance "Care, not death", Dr. P. Saunders, believes the same. In his opinion, legislators are unable to allow euthanasia without expanding the range of categories of persons who supposedly have the right to it. If in some conditions it is possible to take people's lives, which supposedly do not need to be continued, the expansion of the list of such conditions is inevitable. Accordingly, the process will get out of control and the only possible option here remains a complete ban on any form of euthanasia [7].

Another position is taken by A. Zaporozhchenko, who points to the legal aspect of understanding euthanasia, which creates the basis for realizing the right to die with dignity and easily. The right to die easily and with dignity is used as the main means of decriminalization of euthanasia, its interpretation as one of the forms of realization of the right to life in the aspect of disposal of life [8, p. 34].

O. Dzyubenko also convinces that human life is the highest value, and the state must guarantee the provision of human rights to life, health and at the same time death. Only the person himself should decide which rights to exercise, including the right to dispose of his life, and the state, through the adoption of an appropriate law with clearly defined grounds and procedure for euthanasia, should ensure that the person realizes this right, since euthanasia ends the suffering and torment of a person, makes it possible legally, without committing suicide, to end one's own life with dignity by one's own will [9, p. 67].

The third approach is demonstrated by M. Gromovchuk, in whose opinion the right to euthanasia contradicts the human right to life, and therefore, instead of promoting euthanasia as a method of solving problems, the state should focus the efforts of specialists on finding ways to reduce mortality and ensure a dignified life, even in conditions of incurable diseases. The author sees a way out in the quality provision of "palliative care" [10, p. 32].

Thus, it can be concluded that euthanasia is considered from a scientific point of view in Ukraine in three aspects: 1) negative - support for the current ban on euthanasia; 2) positive - the need to create legal instruments to implement the right to voluntarily end one's own life; 3) alternative - supporters of which consider the possibility of replacing euthanasia with other, more humane procedures from the point of view of bioethics (palliative care, voluntary refusal of treatment, etc.).

If we look at the problem of euthanasia from a different sight, part 6 of Article 13 " Conditions and procedure for the application of transplantation" of the Law of Ukraine "On the application of transplantation of anatomical materials to a person" provides the following: "If, after the explanations given by the doctor, the recipient refuses the application of transplantation, the doctor has the right to offer the recipient to submit a written statement on refusal to provide him with medical assistance with the use of transplantation. In the case of the recipient's refusal to provide such a written statement or the impossibility of providing it, including due to the state of health, the doctor draws up an appropriate act in the presence of witnesses" [11]. That is, the recipient' s refusal to receive a donor organ actually deprives him of the opportunity to live, bringing the moment of death closer. Thus, in certain, legally defined cases, an individual in Ukraine nevertheless has the right to freely manage his own life.

As for the criminal responsibility for euthanasia in Ukraine, one should agree with S. Shcherbak and M. Kozodav that in the modern theory of criminal law science of Ukraine it is recognized that the consent of another person to take his life or the presence of his request to take his life does not eliminate of the illegality of an act aimed at depriving the life of such a person, and does not exempt the subject who commits it from criminal liability. On the other hand, there is a question of how to qualify euthanasia according to the norms of the Criminal Code of Ukraine [12, p. 143].

Here, S. Romanov and Ya. Trynyova point out that the legislation of many countries, including Ukraine, does not provide for the procedure of euthanasia, while it is still found in the practical activities of medical workers. In the Criminal Code of Ukraine, there are a number of articles that provide for the death of a person in case of criminal consequences: 115-120, 129, 297. Thus, the law already foresees the fact of death as a consequence. But the law is silent about when a person has not yet died, but is allegedly no longer alive. This period of human existence is not prescribed by law, although thanks to supportive medical measures it can last for months and years [13, p. 105].

When considering the issue of euthanasia, it is worth paying attention to the fact that a terminally ill (suffering) person can always commit suicide, which can be a consequence of his desire to stop suffering from the disease. Cases of such suicides tend to increase all over the world. Among the possible reasons for the termination of life are disbelief in the effectiveness of the health care system, the possibility of recovery, as well as the insufficient development of palliative care.

O. Ishchenko and A. Mazyar note that the problem of euthanasia is mainly a problem of choice: a person, a doctor and society [14, p. 39]. Thus, the society of every democratic state in the world faces a choice whether to legalize the right to euthanasia, or what should be the responsibility in case of banning the mentioned procedure.

Norms of international law treat euthanasia with a caveat, not indicating a direct prohibition of this procedure, but emphasizing its unethicality. In October 1987, at the 39th plenary session of the World Medical Assembly, the Declaration on euthanasia was adopted (Madrid, Kingdom of Spain). The mentioned document stipulates that euthanasia as an act of intentionally taking a patient's life, even at his own request or at the request of his relatives, is not ethical. This does not exclude the need for a doctor's respectful attitude to the patient's desire not to interfere with the course of the natural process of dying in the terminal phase of the disease [15, p. 342]. That is, we see here a reference to the "non-interference" of a medical worker in the event of a patient's refusal of treatment. However, such a refusal cannot be equated with euthanasia, as the right to die voluntarily at a time determined by the patient himself, with dignity and without pain.

Conclusions

In conclusion, we return to the key thesis of our research, what is euthanasia - a right or a crime? International practice indicates further liberalization and expansion of the circle of states that support euthanasia procedures. Moreover, legal safeguards to prevent the abuse of this right differ significantly in each state. Speaking about the procedures and forms of euthanasia, it is difficult to say which of them is the most acceptable, but they all imply one thing - the right of a terminally ill person or a person suffering from a chronic disease to independently determine how and when to die. Euthanasia is a person's own choice and it is the most important thing in his awareness as a component of the right to life.

On the other hand, euthanasia is a criminal offense - a crime. There is no specialized provision on euthanasia in the domestic Criminal Code, which reduces the possible procedures for its implementation to one or another form of intentional murder.

We stand on the position of the possibility of legalizing euthanasia in Ukraine. We believe that the right to a dignified death will testify to the maturity of the development of democratic values in Ukraine. Likewise, the readiness of Ukrainian society to accept euthanasia will result in changes and additions to the national legislation for a positive solution to this issue.

Conflict of Interest and other Ethics Statements

The author declares no conflict of interest.

References

1. Тофтул М.Г. Сучасний словник з етики. Житомир: Вид-во ЖДУ ім. І. Франка. 2014. 416 с.

2. Конституція України: Закон України від 28.06.1996 № 254к/96-ВР URL: https://zakon.rada.gov.uaЛaws/show/254к/96-вр#Text.

3. Цивільний кодекс України: Закон України від 15.01.2003 № 435-TV. Відомості Верховної Ради України. 2003. Додаток до № 40. Ст. 356.

4. Науково-практичний коментар до Закону України «Основи законодавства України про охорону здоров'я» / Борис Логвиненко. Київ: ВД «Дакор». 2021. 272 с.

5. Гайдачук І.В. Право людини на евтаназію: міжнародно-правове закріплення та практика. Міжнародні читання з міжнародного права пам'яті професора П.Є. Казанського: матеріали четвертої міжнар. наук. конф. (м. Одеса, 8-9 лист. 2013 р.) / відп. за випуск к.ю.н., доц. М.І. Пашковський. Національний університет «Одеська юридична академія». Одеса: Фенікс. 2013. С. 225-228.

6. Zaharov V., Shapovalova I. Sociological and legal aspects of euthanasia. Philosophy, Economics and Law Review. 2021. 1(1). Р. 182-189.

7. У Голландії піддали евтаназії фізично здорову дівчину з психічними відхиленнями.

8. УШАН. 02.02.2018. URL: https://religions.unian.ua/religionsworld/2379340-u-gollandiji-piddali-evtanaziji-fizichno-zdorovu-divchinu-z-psihichnimi-vidhilennyami.html.

9. Запорожченко А.О. «Евтаназія» та «право померти легко та гідно»: квінтесенція термінів та їх співвідношення. Прикарпатський юридичний вісник. 2014. 3(6). С. 26-36.

10. Дзюбенко О.Л. Актуальні аспекти легалізації евтаназії в Україні. Юридичний науковий електронний журнал. 2019. № 1. С. 64-67. URL: http://www.lsej.org.ua/1_2019/17.pdf.

11. Громовчук М. Евтаназія в Україні: питання реалізації конституційного права людини. Український часопис конституційного права. 2021. № 2. С. 28-33.

12. Про застосування трансплантації анатомічних матеріалів людині: Закон України від 17.05.2018 № 2427-VH1. Відомості Верховної Ради України. 2018. Додаток до № 28. Ст. 232.

13. Щербак С.В. Евтаназія в кримінально-правовій науці. С.В. Щербак, М.Ю. Козодав. Приватне та публічне право. 2021. № 4. С. 140-145.

14. Романов С.Ю. Евтаназія: етичний та кримінально-правовий аспект. С.Ю. Романов, Я.О. Триньова. Вісник Харківського національного університету внутрішніх справ. 2002. Вип. 19. С. 101-106.

15. Іщенко О.М. Евтаназія за кримінальним законодавством України / О.М. Іщенко, А.К. Мазяр. Молодий вчений. 2017. № 5.1 (45.1). С. 39-41.

16. Корчака Є.О. Права людини четвертого покоління. Порівняльно-аналітичне право. 2017. № 4.С. 341-342.

References

1. Toftul M. Gh. Suchasnyj slovnyk z etyky [Modem dictionary of ethics]. Zhytomyr: Vyd-vo ZhDU im. I. Franka. 2014. 416 p. [in Ukr.].

2. Konstytucija Ukrajiny [Constitution of Ukraine]: Zakon Ukrajiny vid 28.06.1996 № 254k/96-VR URL: https://zakon.rada.gov.ua/laws/show/254к/96-вр#Text. [in Ukr.].

3. Cyviljnyj kodeks Ukrajiny [Civil Code of Ukraine]: Zakon Ukrajiny vid 15.01.2003 № 435-LV. URL: https://zakon.rada.gov.ua/laws/show/435-15#Text. [in Ukr.]

4. Naukovo-praktychnyj komentar do Zakonu Ukrajiny "Osnovy zakonodavstva Ukrajiny pro okhoronu zdorov'ja" [Scientific and practical commentary on the law of Ukraine: Fundamentals of the Legislation of Ukraine on Healthcare] / Borys Loghvynenko. Kyiv: Dakor. 2021.272 p. [in Ukr.].

5. Ghajdachuk I.V. Pravo ljudyny na evtanaziju: mizhnarodno-pravove zakriplennja ta praktyka [Human right to euthanasia: international legal consolidation and practice]. Mizhnarodni chytannja z mizhnarodnogho prava pam'jati profesora P.Je. Kazansjkogho: materialy chetvertoji mizhnar. nauk. konf. (Odesa, 8-9. November 2013) / vidp. za vypusk k.ju.n., doc. M.I. Pashkovsjkyj; Nacionaljnyj universytet «Odesjka jurydychna akademija». Odesa: Feniks, 2013. P. 225-228 [in Ukr.].

6. Zaharov V., Shapovalova I. Sociological and legal aspects of euthanasia. Philosophy, Economics and Law Review. 2021. 1(1). Р. 182-189 [in Eng.].

7. U Ghollandiji piddaly evtanaziji fizychno zdorovu divchynu z psykhichnymy vidkhylennjamy [In Holland, a physically healthy girl with mental disorders was subjected to euthanasia]. UNIAN. 2018. URL: https://religions.unian.ua/religionsworld/2379340-u-gollandiji-piddali-evtanaziji-fizichno-zdorovu-divchinu-z-psihichnimi-vidhilennyami.html. [in Ukr.]

8. Zaporozhchenko A.O. "Evtanazija" ta "pravo pomerty leghko ta ghidno": kvintesencija terminiv ta jikh spivvidnoshennja ["Right to Die with Dignit"», "Euthanasia": Notions and Their Correlation]. Prykarpatsjkyj jurydychnyj visnyk. 2014. 3(6). P. 26-36. [in Ukr.].

9. Dzjubenko O.L. Aktualjni aspekty leghalizaciji evtanaziji v Ukrajini [Actual aspects of euthanasia legalization in Ukraine]. Jurydychnyj naukovyj elektronnyjzhurnal. 2019. No. 1. P. 64-67. URL: http://www.lsej.org.ua/1_2019/17.pdf. [in Ukr.].

10. Ghromovchuk M. Evtanazija v Ukrajini: pytannja realizaciji konstytucijnogho prava ljudyny [Euthanasia in Ukraine: issues of implementation of constitutional human right]. Ukrajinsjkyj chasopys konstytucijnogho prava. 2021. No. 2. P. 28-33. [in Ukr.].

11. Pro zastosuvannja transplantaciji anatomichnykh materialiv ljudyni [On the application of transplantation of anatomical materials to humans]: Zakon Ukrajiny vid 17.05.2018 № 2427-VIn. URL: https://zakon.rada.gov.ua/laws/show/2427-19#Text. [in Ukr.].

12. Shherbak S.V. Evtanazija v kryminaljno-pravovij nauci. S.V. Shherbak, M.Ju. Kozodav [Euthanasia in criminal science]. Pryvatne tapublichnepravo. 2021. No. 4. P. 140-145. [in Ukr.].

13. Romanov S.Ju. Evtanazija: etychnyj ta kryminaljno- pravovyj aspekt / S.Ju. Romanov, Ja.O. Trynjova [Euthanasia: ethical and criminal law aspect]. Visnyk Kharkivsjkogho nacionaljnogho universytetu vnutrishnikh sprav. 2002. Vol. 19. P. 101-106. [in Ukr.].

14. Ishhenko O.M. Evtanazija za kryminaljnym zakonodavstvom Ukrajiny [Euthanasia under the criminal law Ukraine] / O.M. Ishhenko, A.K. Mazjar. Molodyjvchenyj. 2017. No. 5.1 (45.1). P. 39-41. [in Ukr.].

15. Korchaka Ye.O. Prava ljudyny chetvertogho pokolinnja [Human rights of the fourth generation]. Porivnjaljno-analitychnepravo. 2017. No. 4. P. 341-342. [in Ukr.].

Размещено на Allbest.ru