Integral ecology

"In a healthy society no one would have to wonder if there are any leftovers."

The round table "On euthanasia: reclaiming a sense of dignity, care and autonomy." promoted by the Core Curriculum Institute of the University of Navarra addressed the issue of euthanasia in an interdisciplinary manner. 

Maria José Atienza-April 22nd, 2021-Reading time: 4 minutes

Photo: ©Olga Kononenko/ Unsplash

What can we do once the euthanasia law is passed? The Core Curriculum Institute of the University of Navarra held yesterday the roundtable discussion "On euthanasia: reclaiming a sense of dignity, care and autonomy." in which this issue has been approached from the fields of medicine, law, public opinion and philosophy.  

Carlos Centeno, director of the Palliative Medicine Service of the Clínica Universidad de Navarra; Teresa Sádaba, professor of Communication; José María Torralba, professor of Ethics; and Pilar Zambrano, professor of Philosophy of Law were the speakers at this round table moderated by Mercedes Pérez Díez del Corral, dean of the School of Nursing.

Today's medicine erases the idea that "one must die in pain".

The first to speak was Dr. Carlos CentenoHe focused his presentation on the idea that with good medicine it is possible to die in peace and without suffering. To this end, he described advances and medical practices that are currently being carried out and that combat the idea that "one must die suffering" and did so by means of several real examples of patients with various ailments and stages of the disease. The doctor mainly wanted to highlight the difference between palliative care and euthanasia. While the former seek to alleviate the suffering derived from the disease, euthanasia actively pursues the end of life.

Centeno focused his presentation on three medical practices. The first: the use of the morphinewell administered as "good medicine that avoids intense suffering to the patient". A practice that is not only applied to people close to death but also to people who, because of their illness, suffer a high level of suffering. The palliative sedation has been the second of the practices that helps to eliminate suffering and not the patient, like euthanasia. On this point, Centeno recalled that palliative sedation aims to alleviate suffering and is applied with greater or lesser depth depending on the ailments. Finally, he referred to the adequacy of the therapeutic effortThe acceptance of the disease is "deciding whether a treatment is excessive for a person. That acceptance is to be aware that the disease has reached a limit is to accept, in a way, natural death".

"The new law recognizes the right to request a medical benefit consisting of killing."

The legal approach was provided by Professor Pilar ZambranoZambrano began by distinguishing the concepts of palliative care, adequacy of therapeutic effort and euthanasia. Zambrano stated that it is necessary "to be clear that euthanasia is an action aimed at causing death intentionally and directly".

Zambrano also differentiated between two conceptions of decriminalization. The first is that "the state should abstain from intervening in the face of an individual right. An omission of the State is requested and that there should be no penalization, for example, of a fine in the exercise of what I consider a right".

The second conception, however, "considers that this right must be converted into a service right, that is, that the State must provide the means to make it possible". This is the conception of the recently approved law on euthanasia, which transforms active euthanasia into a benefit right - that the government has to procure, encourage, and train in it. "We are in front of a norm that recognizes the right to request a medical benefit consisting in killing," Zambrano acknowledged.

The question that arises from this regulation is obvious: can a citizen actively oppose this law? A complicated issue, as admitted by the law professor, who recognized that this opposition would be different depending on the role of each person before the law: for example, medical professionals, legislators or politicians themselves.

Knowing the "interpretation frameworks

For her part, the director of ISEM and professor of communication, Teresa Sádaba He addressed the "current frameworks of interpretation in which public opinion approaches euthanasia" and which should be rethought, with the aim of creating a real and fruitful debate on euthanasia that would lead to reflection on the fundamental points at stake. The frameworks of interpretation pointed out by Sádaba are:

  1. Compassion in the face of suffering, especially, showing limit situations. Compassion is considered above all others. Compassion not only with the patient but also with the caregiver or family.
  2. The concept of dignity. In which, according to Sádaba, there is "a terminological confusion", since those who reject euthanasia appeal to an intrinsic dignity while the defenders consider dignity as an adaptation to certain circumstances.  
  3. The trivialization and normalization of these issues.
  4. The presentation of the Church as a dogmatic or ancestral institution, devoid of intelligent reasons.
  5. The consideration of Law as a conquest of individual rights, without limits.
  6. The argument about the role of professionals: the expiration of the Hippocratic oath or statistics as an argument.
  7. Experience from other countries, for or against
  8. Animalism and the consideration or equalization of the rights of animals and human beings.
  9. The business world that also exists in euthanasia.
  10. Advances in science

In conclusion, Teresa Sádaba stressed the importance of creating a bank of trust when dealing with this type of issues from the right perspective.

"Let's build a society proud to take care of its own."

Lastly, the philosopher took the floor José María TorralbaDirector of the Core Curriculum Institute of the University of Navarra, who began by emphasizing that "we are facing a moment of change of worldview. Society has lost the meaning of concepts such as "care", "autonomy" or "suffering". Torralba appealed to the need to recover the meaning of these concepts through education and public debate.

The ethics professor made a call not to close the debate on euthanasia, even though the law has been approved, given that it is "a law that harms the common good and we must work to change the law. We are moved by the conviction that there are truths, such as the value of life, that society should not forget". In this line, he pointed out that "the Christian message must remind us that life is a gift that we receive, that the parameters of utility are not adequate to value a life".

He also stressed that "in situations of suffering, the capacity to love and be loved does not disappear, in fact it becomes more palpable".  

Torralba referred to the two ways of understanding dignity to which Professor Zambrano had alluded: as an intrinsic value or as pure self-determination.

Torralba pointed out that "we should build a society in which no one has to wonder if there is too much, since laws create culture and vice versa". Culture, through media, education and the arts "should create a society proud to take care of its own," he concluded.

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