Pretoria - The Health Professions Council of South Africa (HPCSA) is of the opinion that if euthanasia or assisted suicide is legalised in South Africa, many unscrupulous doctors and healthcare workers might abuse it.
Apart from this, the HPCSA said, many terminally ill people who do not really want to die, will feel obliged to have their lives end as they might be a burden to their families.
With the law on their side to do so, they might forge ahead as they would feel guilty not to.
This is according to counsel acting for the health professions’ watchdog in the preamble to the landmark case in which the court is asked to legalise assisted suicide or euthanasia.
Both the government and the HPCSA are against the law changing in this regard.
Both Diethelm Harck, 71, who suffers from motor-neuron disease, and his former palliative care physician, Sue Walter, are adamant that terminally ill patients should be given a choice to die when the time comes.
Harck took the stand – virtually from his Western Cape home – for the third day in his application, together with his palliative care physician Walter, who suffers from multiple myeloma, for the law to change. At present, the law bars doctors from assisting terminal patients to die.
They are adamant they want to opt for euthanasia or the assisted suicide route when they can no longer face life. They also want other South Africans to have this choice.
While their legal challenge is due to only be heard later this year in the Johannesburg High Court, the pair are now testifying before a commissioner, as they are not sure what the future holds for them.
Harck, the first to testify, has been under cross-examination for two days by counsel for the government and that of the HPCSA.
Harck was questioned at length about literature being available on how terminally ill patients could end their own lives, if they wanted to, when the time came.
But Harck was adamant he wanted a doctor to administer a lethal dose which would kill him if he could no longer face life.
Advocate Adrian D’Óliveira for the HPCSA questioned Harck as to why he wanted to go this route. He pointed out that while the HPCSA was against assisted suicide and euthanasia, there was a lot of literature on the subject available.
But Harck maintained he did not know what the future holds for him. “I don’t know for how long I will be able to take my own life. When the time comes, I want to make the choice to have a medical doctor assist me,” he said.
Harck stressed that while he loved life at this stage and “absolutely” did not want to die now, he feared that when the time came when he wanted to die, but he would not be able to.
D’Oliveira also pointed out that palliative medical specialists were also able to render terminally ill patients unconscious when the time came. “No person needs to experience the type of pain you are afraid of ...Thus there is no need to change the law to provide for assisted suicide,” the advocate said.
Harck, however, said palliative induced unconsciousness was not always effective. He said it was his human right to decide whether he wanted to die when the time came. The primary decision should be with the patient, he said.
DÓliveira also said the HPCSA will argue that if the court changed the law it would be open to abuse. People might feel pressured to choose euthanasia, due to family pressures.
On the other hand, people can be murdered under the guise of euthanasia and assisted suicide, by unscrupulous doctors acting in collusion with the HPCSA, DÓliveira said.
Thus, the HPCSA is in a very difficult position, the advocate said, as the law, if passed, could be abused.
The public health system will also not be able to accommodate euthanasia or medically assisted suicide, D’Oliveira said.
“A small population has the benefit of private health care. The majority must use an overburdened public health care system.”
DÓliveira said it's the case of the HPCSA that where there is a lack of resources or proper care, doctors armed with legislation making euthanasia and assisted suicide legal, could abuse this.
The HPCSA said euthanasia and assisted suicide should not be legalised in South Africa for people’s own good.
*Centre for Applied Legal Studies believes law should change
Some explanations by the Centre for Applied Legal Studies, which has joined the landmark application to legalise assisted suicide in South Africa, as to the legal issues and why they supported the application:
Assisted dying (or physician-assisted dying) involves a person with a terminal illness making the choice to take prescribed medication to end their life. In places where assisted dying is regulated in law, this option is generally open to mentally competent adults making the decision of their own free will and meeting strict legal safeguards.
Euthanasia is generally used to refer to instances in which the person who chooses to die does not end their own life, but has medication administered by another person – usually a doctor.
Assisted suicide and assisted dying may be used interchangeably; however, many advocates prefer using the term “assisted dying” because they believe this is not the same as suicide. People with terminal illnesses are not necessarily suicidal. They do not wish to die; they are already dying. They simply wish to have some control in deciding when and how they will die.
In South Africa, assisted dying is criminalised. While suicide and attempted suicide are not unlawful, assisting someone to end their life is considered an offence. Medical professionals who do so face prosecution and disciplinary hearings. The centre said South Africa would need a change in the law to give terminally ill, mentally competent adults access to assisted dying.
The organisation believes the law should change as many people with terminal illnesses might endure intolerable suffering and want the choice to end their lives while they are still conscious and surrounded by their loved ones.
It says that without access to assisted dying, people are faced with limited options. They are forced either to suffer against their wishes, end their lives unconscious in a medically-induced coma, painfully try to hasten their deaths by refusing treatment and food, or violently end their own lives alone.
Regarding whether legalising assisted dying would put vulnerable people at risk, the centre said there were a number of other countries that legalised assisted dying and developed stringent safeguards to prevent abuse from happening.
Medical professionals are able to assess a terminally ill patient’s request and it is only considered if they are a mentally competent adult asking for this choice of their own free will.
It said should assisted dying be legalised in South Africa, similar independent checks and balances would need to be in place to ensure any request was the choice of the person with a terminal illness, and that they were not influenced or coerced by others.