370 Assisted Deaths Carried Out In Spain During First 18 Months Of New Euthanasia Law

Image of a nurse holding a patient's hand.

Image of a nurse holding a patient's hand. Credit: Patrick Thomas/Shutterstock.com

Since the new law entered into force on June 25, 2021, a total of 370 euthanasias were performed in Spain up until December 2022.

However, according to data released this Thursday, June 22, by the Right to Die with Dignity (DMD) association, there was a ‘great disparity’ in implementation between the autonomous communities.

DMD has painstakingly collected all the information possible to evaluate its implementation, identify failures and successes, and propose ways of improvement since the law was implemented.

As explained in a press conference held by DMD spokesmen Fernando Marín and Fernando Sanz, of these 370 cases, ‘probably more than 1,000 requested it’.

‘This is good news, and the verification that it was a necessary norm. It is to be expected that the number will grow in the coming years, as this right is consolidated among citizens and the response of the health services improves’, they highlighted.

In 2022, euthanasia accounted for less than 0.07 per cent of the total annual deaths in Spain. This percentage, as the two men recalled, is ‘far removed’ from that of countries where the right to assisted dying is well established, where it represents between one and four per cent of all deaths.

‘The implementation is slow compared to other countries close to ours that legislated before, but the important thing is that we have the right, the quantity does not matter so much. It will always be a minority way of dying. The Law itself defines it as an exception’, Fernando Sanz commented.

An initial report from the Ministry of Health, published in February, but referring to the period between June and December 2021, said that 32 people died while processing their request for euthanasia.

They died, on average, 31 days after starting the process. This same report stated that there were 28 requests that never reached the Commission for Guarantees and Evaluation of Euthanasia (CGE). Another 25 applications were denied. Up to seven people interrupted the processing of their euthanasia.

Percentages varied between communities

The percentage in Spain was not homogeneous between communities. While in Navarra, Catalonia, La Rioja or the Basque Country more than one euthanasia was performed for every thousand deaths (less than 0.1 per cent), in other territories such as Murcia, Extremadura, and Galicia, assisted death had an incidence ten times lower, of just over 0.01 per cent.

Another nine were carried out in Asturias (0.064 per cent); six in the Balearic Islands (0.063 per cent); ten in the Canary Islands (0.053 per cent); eight in Aragon (0.052 per cent); 26 in the Valencian Community (0.051 per cent); eight in Castilla-La Mancha (0.038 per cent); 29 in Andalucia (0.036 per cent); ten in Castilla y León (0.031 per cent); three in Extremadura (0.024 per cent); eight in Galicia (0.022per cent); and two in Murcia (0.015 per cent).

For DMD, this was ‘a very marked disparity, difficult to explain by sociocultural differences alone ‘. For this reason, DMD suspected that these differences between CCAAs were due rather to a lack of accessibility and implementation. Through a study, they verified ‘great inequalities’ between autonomous communities and suggested that some have done ‘a better job of implementing the Law’.

Among the individual known cases of DMD, some difficulties stand out from the rest because of their frequency or severity. For example, they verified that on some occasions there had been a ‘lack of collaboration from private entities’ that ‘have not responded to requests for euthanasia received’.

Conscientious objection was mishandled

Similarly, there had sometimes been a ‘mishandling of conscientious objection. The obligation of all doctors is to collect any request for euthanasia that is presented to them, sign it and process it. In the case of conscientious objectors, they must inform their patients of this condition and send the request to their bosses so that they can find another doctor.

‘We are aware of cases of doctors who refused to do so, as well as excessive deadlines to designate an alternative professional’, the DMD experts detailed.

Excessive deadlines were also a problem

Another problem was ‘excessive deadlines’. According to their information, in many communities, the average duration of an aid-in-dying benefit (from the first request to the favourable report from the Guarantee and Evaluation Commission) was ‘much longer than the terms provided by legislators. Although the entire process should last around 35 days, they often extend beyond 50’, they pointed out.

Although the Law does not set maximum deadlines for some critical phases of the processing of a euthanasia request, the Right to Die With Dignity lamented that ‘it is not reasonable that there are still people who require several months to complete a process that, in the correct circumstances adequate, can get it done with all the guarantees in less than 25 days’.

Information was often ‘scarce, heterogeneous and hollow’

The DMD association also lamented that after 24 months the information offered by the administrations was ‘scarce, heterogeneous and often hollow’.

Two years after the entry into force of the law, and, although all the autonomous communities have shared data with the Ministry of Health, not all have made their annual reports public despite the fact that the Law requires it.

DMD explained that the Interterritorial Council of the National Health System (CISNS) agreed on a ‘minimum’ and ‘insufficient’ set of data that should appear in these reports. Furthermore, ‘not all communities have respected them’.

In addition, DMD criticised that the reports, both from communities and from the Ministry, ‘overlook a great anomaly that is hidden among the data’.

While in Belgium, Canada and the Netherlands, 80 per cent of patients who resort to euthanasia are terminally ill, especially with cancer, which accumulates two out of three cases, in Spain this figure was less than half.

Neurodegenerative diseases (ALS, multiple sclerosis, etc.) predominated in assisted dying in Spain concluded DMD, as reported by 20minutos.es.

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Written by

Chris King

Originally from Wales, Chris spent years on the Costa del Sol before moving to the Algarve where he is a web reporter for The Euro Weekly News covering international and Spanish national news. Got a news story you want to share? Then get in touch at editorial@euroweeklynews.com