Medical and social aspects of euthanasia of palliative patients in the Netherlands, Belgium and Germany

Abstract

In the palliative and hospice medicine of Ukraine, there are a number of unresolved legal and organizational problems that stand in the way of a dignified existence of hopelessly ill patients in the last days and months of their lives. First of all, these are unresolved issues with the coverage of treatment and care of a sufficient number of categories of patients: palliative care is provided mainly to patients with oncological, cardiovascular and neurological profiles of treatment. Secondly, it is the lack of adequate analgesia for a significant number of inpatients and the vast majority of patients receiving treatment at home. Availability of recently legalized medical cannabis remains low for palliative care patients, and palliative care euthanasia is not legalized. In our previous research, we found out that Ukrainian society is not ready for a dialogue about the need to legalize euthanasia, and that the best model of preparing society for euthanasia is the Canadian one, which is based on a comprehensive study of the opinions of the general public and direct participants of the Medical Assistance in Dying (MAiD), as well as on the implementation of decisions federal court. The article is devoted to legal procedures and socio-medical aspects of euthanasia and MAiD in the Netherlands, Belgium and Germany. Certain aspects of legalization, its context and circumstances, compared with the conditions of Ukraine. The article is an original theoretical study performed using the method of systematic analysis, comparative and bibliosemantic methods. Note that we are clarifying the terminology of the previous stages of the study: MAiD is performed by the patient himself, euthanasia is performed by the doctor. In our opinion, Ukraine needs the legalization of euthanasia and MAiD for all age categories, and with the implementation of special additional consent procedures for adult incapacitated patients. In the experience of the countries of the current comparison, we paid special attention to the prevention of abuses in the implementation of these procedures, in the conditions of frequent disregard for the norms of the law since the beginning of the war. Keywords: palliative and hospice care, suicides of palliative patients, Medical Assistance in Dying, right to life, right to die.