Lipp-WMA EoL Presentation Vatican-Nov2017

11/23/17
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Euthanasia and PAS
WMA European Region Meeting
on End-of Life Questions
16 November 2017
Prof. Dr. Dr. h.c. Volker Lipp
Introduction
• Euthanasia – an ambigous concept
• Analytical usage vs. normative usage
• Ethics – Human Rights – (National) Legal
Systems
• Common Law Countries – Civil (Roman) Law
Countries
• All legal systems differ – Is there one great
divide?
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Prof. Dr. Dr. h.c. Volker Lipp
Definitions
• Assisted Suicide – intentionally killing oneself
with the assistance of another person
• PAS – suicide with assistance of a physician
• Euthanasia – intentionally killing another
person in order to relieve this person‘s
suffering (voluntary, non-voluntary,
involuntary)
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Prof. Dr. Dr. h.c. Volker Lipp
Definitions
• (rep.) Euthanasia – intentionally killing
another person in order to relieve this
person‘s suffering (voluntary, non-voluntary,
involuntary)
• „Letting die“ – limitating, terminating,
withholding life-sustaining treatment because
it is futile or according to the patient‘s will
(sometimes also called „passive euthanasia“)
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Prof. Dr. Dr. h.c. Volker Lipp
Overlapping?
• (Physician-assisted) suicide
• Voluntary euthanasia
• Terminating or withholding life-sustaining
treatment according to the patient‘s will
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Prof. Dr. Dr. h.c. Volker Lipp
Human Rights
• European Convention on Human Rights (1950)
• European Court of Human Rights
– no consensus amoung Council of Europe
member states
– wide margin of appreciation for member
states
– several complaints declared inadmissible
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Prof. Dr. Dr. h.c. Volker Lipp
11/23/17
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Human Rights
• European Court of Human Rights on (P)AS
– no violation of ECHR if state prohibits
assisting another person‘s suicide
(„Diane Pretty“, 29.4.2002)
– no violation of ECHR if state does not
provide access to lethal drug without
prescription in order to commit suicide
(„Haas“, 20.1.2011)
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Prof. Dr. Dr. h.c. Volker Lipp
Human Rights
• European Court of Human Rights on (P)AS
– violation of ECHR if state does not examine
the merits of a claim for access to lethal drug
in order to commit suicide
(„Koch“, 19.7.2012)
– overruling of „Haas“ by Chamber but
judgment of 14.5.2013 did not become final
(„Gross“, Grand Chamber, 30.9.2014)
• Note: German Federal Administrative Court (2.3.2017)
– access to lethal drug in order to commit suicide granted by
German constitution in extreme cases
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Prof. Dr. Dr. h.c. Volker Lipp
Human Rights
• European Court of Human Rights
– no violation of ECHR if state allows
withdrawal of life-sustaining treatment
(5.6.2015 „Lambert“)
– So far no decision on euthanasia apart from
„Lamb“ (23.6.2015, complaint against UK
ban on voluntary euthanasia inadmissible)
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Prof. Dr. Dr. h.c. Volker Lipp
“Letting die”
• Limitating, terminating, withholding life-
sustaining treatment is widely accepted in
principle, but conditions vary, e.g.
• Limited to patients who are terminally ill?
• Also for patients incapable to decide? And
who is to decide for them?
• Significance of advance directives
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Prof. Dr. Dr. h.c. Volker Lipp
Euthanasia
• Most European countries ban all forms of
euthanasia by criminal law
• NL, B and L have legalized voluntary
euthanasia by a physician for adults, NL and B
also for minors (conditions differ)
• The Netherlands also allow (non-voluntary)
euthanasia of newborn babies that are
terminally ill (under conditions laid down in
the „Groningen protocol“)
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Prof. Dr. Dr. h.c. Volker Lipp
Physician-Assisted Suicide
• Group 1 (e.g. Austria): Ban on all forms of
assisted suicide (and euthanasia)
• Group 2 (e.g. D): Euthanasia and some forms of
assisted suicide including PAS are banned
• Group 3 (e.g. CH): Euthanasia is banned but
assisted suicide including PAS is legal under
certain conditions
• Group 4 (e.g. NL, B, L): PAS is legal under
conditions similar to those for voluntary
euthanasia
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Prof. Dr. Dr. h.c. Volker Lipp
11/23/17
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Access to lethal drug
• Access to lethal drug in order to commit suicide
• Access regulated
– prescription by physician
→ PAS
– grant of access by regulating authority
→ case law of Europan Court of Human Rights
and of German Federal Administrative Court
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Prof. Dr. Dr. h.c. Volker Lipp
Thank you for listening!
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Prof. Dr. Dr. h.c. Volker Lipp