Cuba approves law for ‘death with dignity’. What could possibly go wrong?
On the Friday before Christmas, the Cuban parliament passed a new health law acknowledging the right of terminally ill Cubans to refuse to artificially prolong their lives or to opt for a “dignified” death.
The legislation, unanimously approved by the National Assembly of People’s Power (Asamblea Nacional del Poder Popular), will come into effect when regulations for its implementation have been approved by the Ministry for Health.
The new law recognizes individuals’ right “to access a dignified death through the exercise of determinations for the end of life, which may include limiting therapeutic efforts, continuous or palliative care, and valid procedures to end life.” The procedure specifically mentions patients with degenerative and irreversible chronic illnesses who are experiencing unbearable suffering in the terminal phase of life.
In plain speech, Santa Claus brought Cubans euthanasia as a Christmas present.
According to Leonardo Pérez Gallardo, president of the Cuban Society of Civil and Family Law, this law legitimizes a right which was debated during discussions leading up to the 2022 approval of the Family Code, which legalised same-sex marriage, same-sex adoption and altruistic surrogacy.
The recent “debate” in the National Assembly consisted mostly of bouquets to the wisdom and eloquence of its authors. Dr Taymí Martínez Naranjo, a member of the government’s inner cabinet, the Council of State, was glowing in her praise of this essentially pro-life measure. It affirms, she said:
“the right of individuals to access a dignified death through the exercise of determinations for the end of life, and to decide on the course of their illness based on the bioethical principles of autonomy, beneficence, and justice. Today, we are discussing a law that places respect for the lives of human beings and their most important right at the centre: the ability to decide.”
It comes as something of a surprise that a Marxist country like Cuba with ostensibly strong communitarian values should opt for euthanasia. But the first state in the world to legalise euthanasia was Soviet Russia, in 1922 – although it rescinded the law after a few months to avoid abuse.
Cuba may be the poorest country to legalise the right to die and is certainly the first authoritarian regime to do so. This could lead to problems, as bioethics commentator Wesley J. Smith noted sardonically in the National Review:
“Swell. Cuba is a very poor country with people having access to general practitioners, but the country is plagued by medicine shortages and run down facilities. Indeed, according to the Miami Herald, poor access to medical care is one reason Cubans immigrate or flee the country.
Poor quality care and socialized medicine are a toxic combination, perhaps even leading to people being driven to euthanasia or lethal jabs becoming a substitute for care, both of which appear to be happening in Canada.
Then, there is the possibility of euthanasia being used as a cover for political murders in a ruthless tyranny. Hey, what happened to that political dissident? Oh, he asked for “death with dignity.” Aww, compassion!
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One country which will almost certainly keep a close eye on developments in Cuba will be China. They both have low birth rates and ageing populations. In Cuba 16 percent of the population is 65 or over; in China, 14 percent. The inevitable consequence of this will be a huge burden on their healthcare systems. Euthanasia could be a safety valve to cut costs.
There have been no moves by the government to legalise euthanasia in China – none that have become public, at least. However, it is being discussed. A 2017 editorial about end-of-life care in the government newspaper, the People’s Daily, concluded: “Life is accidental, death is inevitable. If life is a ship, everyone is the helmsman of this ship. Letting life end perfectly should not become a luxury wish.”
In 2019 Zhang Di, a bioethicist at Peking Union Medical College, wrote that attitudes towards euthanasia are changing. He said that the country was not ready for it because its healthcare system was too weak. Without good palliative care, people would feel pressured to accept an early death.
Work must also be done to raise awareness of euthanasia among the Chinese public and explain how it would fit in with the country’s traditional family ethics, which stress filial piety and caring for one’s parents. In particular, the media and authorities should make it clear that euthanasia is a choice for some, rather than the only choice for all patients, and stress that no one should ever be pressured into undergoing the procedure.
This sounds remarkably like the oleaginous rhetoric of right-to-die lobbies in Western countries – or of the Asamblea Nacional del Poder Popular de Cuba. It could signal a first step toward the legalisation of voluntary euthanasia in the country with the world’s largest number of over 65s. In 2022 about 13,000 Canadians were euthanised, about 4 percent of all deaths. If euthanasia became that successful in China, there would be at least 400,000 euthanasia deaths every year.
It’s strange to note how much emphasis the silver-tongued Dr Martinez placed on autonomy in her speech on the new health law. Cubans may not have autonomy choose their politicians, but they will have autonomy to choose euthanasia. Oh well, freedom may need to come by baby steps …
Michael Cook is editor of Mercator
Image credit: Bigstock
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