South Africa has recently been divided in a debate concerning the topic of assisted suicide. The debate was spurred on by a judgement made by Pretoria High Court Judge Hans Fabricius on 30 April, allowing the terminally ill Robin Stransham-Ford to end his life with the help of his doctor. Although a controversial topic, Judge Fabricius has stood by his ruling because although the judgement would not benefit the patient himself, as he passed away just two hours before the judgement was handed down, he felt it would still benefit the citizens of South Africa.
According to a News24 article published on 5 May titled “Assisted suicide order stands, judge rules”, the main reason for allowing Stransham- Ford’s euthanasia was that Judge Fabricius felt that absolute prohibition on assisted suicide does not accord with the right to human dignity, freedom and security, which is protected by the South African Constitution. Instead of the sacredness of life itself being seen as paramount, he believes that the sacredness of the quality of life should rather be accentuated.
Thus, a terminally ill patient should be allowed to die with dignity if it is their wish to do so. Regarding the state’s prohibition of assisted suicide, Judge Fabricius stated, “It is noticeable, unfortunate and disturbing that societies in various parts of the world acquiesce in thousands of deaths caused by weapons of mass destruction. They tolerate horrendous murder rates in a number of countries, yearly slaughter on the roads, people dying of Aids, hunger, malnutrition, impure water and insufficient medical facilities. The state says that it cannot afford to fulfil all socio-economic demands, but it assumes the power to tell an educated individual of sound mind who is gravely ill and about to die, that he must suffer the indignity of the severe pain, and is not allowed to die in a dignified, quiet manner with the assistance of a medical practitioner.”
Arguments such as this one only bear in mind the terminally ill individual who is requesting euthanasia, but consideration must also be given to the physician who will actually have to carry out the procedure. It is a reality that some doctors may find difficult to face, however the judgement provides that “no medical doctor is obliged to [agree] to the request of the [patient].” Allowing euthanasia will change the medical industry in South Africa completely. Sixth-year Tuks medical student Jaco van der Westhuizen agrees that doctors should be allowed to assist in a patient’s death and said that he personally would be willing to perform euthanasia. He feels that it is a “humane way of stopping the patient’s suffering and maintaining their dignity when pain medication [can] no longer suffice. It also stops the suffering of the families who have to witness their loved ones suffering.”
When discussing the topic of euthanasia, it is important to note that there are two different ways of performing the procedure. According to the The World Federation of Right to Die Societies, “Assisted death is a model that includes both what has been called physician-assisted ‘suicide’ and voluntary active euthanasia. Physician-assisted suicide entails making lethal means available to the patient to be used at a time of the patient’s own choosing. By contrast, voluntary active euthanasia entails the physician taking an active role in carrying out the patient’s request, and usually involves intravenous delivery of a lethal substance.” One could assume that the latter, voluntary active euthanasia, could possibly take more of an emotional toll on the physician as they are the ones who actively cause the patient’s death. Sixth-year Tuks medical student Xan Smit said that he does not think it would be upsetting to play an active role in assisted suicide because the decision is not made by the doctor but by the patient himself. The doctor is still helping the patient in the same way that they would help any other sick or injured person.
There is, however, some concern that a law allowing euthanasia could be abused. Van der Westhuizen said that if the law is passed, “a bureaucratic wall will be set up with strict criteria set by the Health Professional Council of South Africa.” He does, however, feel that some doctors may be negligent and that some accusations of abuse may be made due to the high emotional state of the situation at hand.
According to a Times Live article titled “The will of the people must prevail on euthanasia law”, in 1998 Nelson Mandela asked the Law Reform Commission to research “assisted suicide and the artificial preservation of life”. The commission favoured assisted suicide and wrote a draft bill. The bill, which was to have been debated in parliament, was given to then health minister Manto Tshabalala-Msimang in 1999, but nothing further was heard of it.
South Africa is yet to find out if the Constitutional Court will formally legalise euthanasia. According to News24, the National Prosecuting Authority (NPA) is appealing the ruling made by the Pretoria High Court. NPA spokesperson Mthunzi Mhaga said that they “are disappointed with the judgment because it has far-reaching implications from a health and constitutional rights point of view, and for the powers of the NPA”. Mhaga said the order affected the powers of the NPA because they would not be able to prosecute the doctor despite euthanasia not being legal in South Africa. If the Supreme Court of Appeal allows the ruling of Judge Fabricius to stand, it could go to the Constitutional Court. This may result in a change of legislation by Parliament.
Judge Fabricius feels that the government should rather allow South Africans to have their say, as a debate will help the legislature to arrive at a better decision. For democracy to be seen to be working, the government should take this matter to the people. As with any debate of a controversial nature, there are always a number of pros and cons thrown into the mix, but hopefully the final verdict will be one that is in the best interests of our society as a whole.
Illustration: Faith Honey