Assisted suicide, it does not violate the right to life if the State punishes it criminally

A state that criminalises assisted suicide does not violate the rights of the sick person, specifically the right to respect for private life, protected by Article 8 of the European Convention on Human Rights. However, access to adequate palliative care must be guaranteed. This is the decision taken by the judges of Strabourg who analysed the case of a Hungarian lawyer suffering from advanced amyotrophic lateral sclerosis, who would like to be helped to die before his suffering becomes too great to bear. But in Hungary this is a criminal offence and anyone assisting a person, at home or abroad, could be prosecuted.

In their judgment, the judges point out that there are potentially wide social implications and risks of error and abuse in the practice of medically assisted death. They also point out that 'despite a growing trend towards its legalisation, the majority of Council of Europe member states continue to prohibit both medically assisted suicide and euthanasia'. Consequently, countries have "a wide margin of discretion in this area" and the ECtHR considers that the Hungarian authorities have not failed to strike a fair balance between the interests at stake and have not exceeded that discretion. But at the same time the Court states that states must consider the need to change the law in order to take into account possible changes in public opinion and international standards of medical ethics in this area. Finally, the Strasbourg judges believe that high-quality palliative care, including access to effective pain management, is essential to ensure a dignified end of life. According to the experts heard by the Court, palliative care, including palliative sedation, is generally capable of providing relief to patients in the situation of the Hungarian man who brought the case. The latter, the international judges pointed out, did not claim that such treatment would not be available to him.

The international courts then denied the discrimination complained of by the plaintiff (Article 14 of the Convention) with respect to terminally ill patients who can refuse treatment or ask for the machines that keep them alive to be stopped. In those cases it is a matter of free consent and not a right to obtain help in dying. A possibility widely recognised and approved by doctors and set out in the Oviedo Convention.

Indeed, the majority of Member States authorise the refusal or interruption of assisted respiration. The Court therefore considers the difference in treatment between two categories of patients to be reasonable and justified.

A verdict that does not seem too much in line with the Consulta's ruling 242/2019. The Consulta on that occasion clearly dictated the conditions for the non-punishability of assisted suicide. The stakes concern the following conditions: irreversible pathology; palliative care; psychological assistance; intolerable physical or psychological suffering; life-support treatment; ability to make free and conscious decisions; opinion of the Ethics Committee; competence of the National Health Service.