There is a growing ongoing debate worldwide around the subject of euthanasia/physician-assisted suicide. It’s an emotive subject ethically, legally and culturally given that the line between euthanasia and murder is a fine one. In South Africa, a 1998 bill by the South African Law Commission that recommended legalising assisted suicide was never passed and remains in limbo 17 years later. Dr Mzukisi Grootboom, chairman of the South African Medical Association, made this point in his presentation at the Board of Healthcare Funders’ 16th annual conference earlier today. His view is that it is an ethical imperative that doctors not use medical treatments to kill, but rather that palliative care in South Africa needs improvement to ensure that patients die naturally, but with dignity, in comfort and without pain.
“The current legal position is that while refusal of treatment is a patient’s basic right, assisted suicide is unlawful and criminal. The primary aim of the doctor during the terminal phase is to ensure optimal quality of life, including addressing psychosocial factors,” he said.
By way of a contrary view he pointed out that some regard assisted suicide as the ultimate expression of liberal individualism, which is supported by the Constitution. “However, Dr Daniel Ncayiyana, emeritus editor of the South African Medical Journal, has this concern, believing that South Africa is not a safe or appropriate place for doctor-assisted suicide. “Given the severe constraints on our resources, there is a real risk that assisted suicide may become an inappropriate substitute for proper care of the terminally ill.”
Professor Samuel Mokgokong, president of the Health Professions Council of South Africa (HPCSA), underscored that prohibition of the intentional killing of a human being is a cornerstone of society. The HPCSA supports the World Medical Association view that physician-assisted suicide is therefore unethical. The WMA discourages it even if national law allows or decriminalises it under certain conditions. The HPCSA is similarly guided by ethical considerations and deems it unethical, regardless of whether performed at the patient’s request. “In Europe, only the Benelux countries and Switzerland have legalised it. In the USA, it is legal in only three states out of 50, Oregon, Washington and Montana. We feel that our view is in line with that of most of the world, which vindicates our position,” he concluded