Intended for healthcare professionals

News

Colombia becomes first Latin American country to decriminalise assisted suicide

BMJ 2022; 377 doi: https://doi.org/10.1136/bmj.o1219 (Published 16 May 2022) Cite this as: BMJ 2022;377:o1219
  1. Luke Taylor
  1. Bogotá

Colombia’s Supreme Court voted to decriminalise assisted suicide on 11 May, making it the first country in Latin America to allow medical professionals to help end the lives of their patients.

Doctors will now be allowed to administer life ending drugs to patients with serious and incurable conditions that are deemed to prevent them from living a dignified life.

“This is a decisive step for our country to consolidate itself as one of the most advanced in the world when we talk about the right to die with dignity,” said Lucas Correa-Montoya, research director at the human rights advocacy group DescLAB which opened the suit against the government that led to the ruling.

Euthanasia, when a medical professional ends a person’s life with the permission of the patient and their family, has been legal in Colombia since 1997.

Unlike euthanasia, which requires that someone else administers the lethal injection or medication, patients have a more active role in assisted suicide and administer the drugs themselves with the support of doctors.

Adriana González, a Colombian lawyer who oversaw the first legal case of euthanasia in Colombia in 2015, said that the ruling provides an alternative way for people who have a terminal or chronic illness and live in severe suffering to die in a dignified manner.

The ruling should come into effect immediately, meaning that “today a patient who wants to request assisted suicide can do so,” González said. “This extends the framework of the right to die in dignity.”

The “right to die with dignity” is enshrined in Colombia’s 1997 constitution and was used by DescLAB to sue the government and provoke the ruling.

Before the ruling, medical professionals who assisted someone in carrying out suicide could be sentenced to between 16 and 36 months in prison. Some 127 medical professionals were investigated for such crimes between 2010 and August 2021, with one doctor convicted and jailed.1

The Supreme Court’s decision, which was six to three in favour of the ruling, is the latest in a series of high court decisions that have led to Colombia having some of the most progressive medical legislation in Latin America. In January abortion up to 24 weeks was decriminalised in Colombia, and euthanasia was used by someone with a non-terminal illness for the first time.2

To perform assisted suicide doctors must formally diagnose the illness or injury that prevents their patient from living a dignified life, and both parties must formally express their consent.

Juan Carlos Rojas, head of Colombia’s psychiatric association, told The BMJ that the ruling gives medical professionals and their patients more autonomy, because patients can now end their lives without consent from family or partners—which is required for euthanasia.

But although the decision has been lauded by advocacy groups, the reaction from medical organisations has been more muted. Medical professionals were left out of the judicial discussions, causing concern that legislation could be drawn up in a way that does not ensure that medically assisted suicide will be accessible or safe, Rojas said.

“These are legal matters, but the result will ultimately fall on doctors to carry out. Medical professionals are experts on this topic and could have informed the process, but they were never consulted,” he said. He is concerned that without a robust legal framework the practice could be vulnerable to manipulation by unethical doctors or politicians.

Rojas said that a medical commission should have been convened to study the experiences of other countries where medically assisted suicide is legal, such as the Netherlands, Luxembourg, and Canada.

González said that the biggest obstacle to implementing the ruling fairly will be Colombia’s stark economic inequality, which could reduce access to assisted suicide to people who can’t afford healthcare.

References

View Abstract

Log in

Log in through your institution

Subscribe

* For online subscription