Last updated at 8.23pm
A group of 58 University of Malta academics has backed government proposals for the introduction of voluntary assisted euthanasia, while the Cana Movement has warned that the proposed legislation, if approved, would promote a culture where suicide was viewed as a way out of life’s suffering.
The arguments came on the last day of a public consultation on a government document proposing the availability of voluntary assisted euthanasia for terminally ill patients with less than six months to live.
“A carefully regulated AVE law can uphold both individual rights and public safety,” the group of university academics said.
Mentally competent adults with terminal or incurable illnesses should be able to make their own end-of-life decisions, the academics said, emphasising the importance of autonomy and dignity.
“For some patients whose suffering cannot be relieved by even the best palliative care, AVE offers a compassionate alternative.”
The group in a position paper stressed the need to respect Malta’s diverse beliefs, allowing those who object to AVE to abstain, while not imposing a single moral viewpoint on everyone.
Healthcare providers, they added, should have the right to conscientious objection.
The academics pointed to evidence from other countries showing that voluntary euthanasia was not disproportionately accessed by vulnerable groups, and that in some instances, palliative care services had improved where AVE has been introduced.
Expansions of eligibility in other countries had only happened through transparent, democratic processes, and there was no proven link between euthanasia laws and an increase in non-assisted suicide rates.
“A well-designed AVE law, with strict oversight and safeguards, can protect the vulnerable, support palliative care, and honour the autonomy of those facing unrelievable suffering.”
They called for careful, compassionate legislation and ongoing public debate on this complex issue.
Euthanasia will make suicide a way to get out of life’s problems, Cana warns
Earlier, the Church’s Cana Movement has warned that the introduction of voluntary assisted euthanasia will cheapen the value of life and make suicide a way to get out of life’s problems.
‘Malta, it insisted, should not follow such overseas trends and should not succumb to ideological colonialism.
“What is being proposed is not a sign of progress,” it insisted.
“It is rather, a return to times when the weak were considered a burden, sidelined and considered unworthy to continue to live.”
The group insisted that the best positive palliative care should be provided so that patients could be able to face their suffering serenely with dignity and hope.
It warned that euthanasia meant that society would be looking at life as a matter which was disposable.
“Should society permit assisted suicide, this will inevitably foster a culture where suicide is considered a choice which can be availed of when confronting hardship, particularly by those suffering emotional and psychological problems,” Cana said.
An environment would be created where those going through a hard time may think that it is better to commit suicide than become a burden on others, it warned.
Graffitti wants wider eligibility criteria for euthanasia
Moviment Graffitti said it backed assisted voluntary euthanasia, saying people should have the right to choose to end their suffering when faced with terminal ‘or incurable illnesses.’
The group said it was concerned about eligibility being limited to a six-month prognosis. “This timeframe is arbitrary and exclusionary, potentially harming patients’ psychological wellbeing by pressuring them into rushed decisions. Instead, we propose that the law should allow assisted voluntary euthanasia for all individuals suffering from incurable, life-limiting physical illnesses that severely impact quality of life,” it said.
Furthermore, the proposed exclusion of disabilities or illnesses associated with old age was overly broad and subjective, risking unjust denial of access and legal uncertainty for both patients and healthcare providers, it said.
It argued that private institutions should be excluded from providing the service of assisted voluntary euthanasia, in order to ensure continued accessibility and to prevent euthanasia from becoming a means of monetary profiteering.
Graffitti also stressed the need to improve healthcare structures including palliative care.
Campaign group delivers 11,571 submissions against euthanasia
The Life Network Foundation, which campaigned against the government’s proposals, said that as part of its Oqtol l-Ugigħ, Mhux Lili, it delivered 11,571 submissions to the Office of the Prime Minister.
Tonio Fenech, the foundation’s chairman, said the submissions supported the growing chorus calling on the government to prioritise compassionate, life-affirming palliative care over the legalisation of assisted suicide.
The foundation said that over the consultation period, 42 organisations had expressed their clear position against the proposed introduction of voluntary assisted euthanasia.
In the medical sphere, those working most closely with patients with terminal illnesses and disability had come out strongly against the proposals, including Hospice Malta, St. Michael Hospice, Palliative Care Association of Malta, MFOPD Malta Federation of Organisations Persons with Disability, Dar tal-Providenza and the Department of Disability Studies at the University of Malta
Also declaring their opposition were the Medical Association of Malta (MAM), the Malta Association of Public Health Medicine (MAPHM), the Maltese Association of Psychiatry (MAP) and the Chamber of Pharmacists.
Opponents also included organisations that worked amongst the vulnerable like Caritas, Dar Hosea, Dar Merhba Bik, Fondazzjoni Sebħ, JRS, OASI Foundation, Segretarjat Assistenza Socjali (AKM), and SOS Malta.
The foundation also noted the opposition of 135 academics under the umbrella of the University of Malta Academic Group.
Fenech said that in countries where euthanasia had been legalised, there was pressure to extend the option to those who were not just terminally ill, but also to those who had disabilities and mental health issues. Palliative care had also seen a drop in investment in these countries, he added.
The group’s CEO, Miriam Sciberras, said the government’s proposal was intrinsically harmful.
“It fails to address the shortage of basic pain relief medication and palliative care. Out of 173 medicines that are related to palliative care, only 19 of these are available in Malta, many of them only in the private healthcare sector,” she said.
Sciberras said there were several issues in the wording of the government’s proposal, including the definition of the phrase ‘terminal illness’.
“Terminal can mean many things. We all know someone who was given months to live, only for them to live rich lives for several more years,” she said.
She questioned whether terminally ill patients were in a position to make such a choice.
“We are putting pressure on vulnerable people, who in that moment need our support to ease their pain. Should we be giving them the option of death?”
Sciberras said none of the safeguards mentioned in the policy document, which would serve to protect the elderly and other vulnerable groups, could be guaranteed.
Caritas concern over people with mental health problems
Caritas Malta in a separate statement also called for the strengthening of the palliative care system and warned that in countries where euthanasia was introduced, initial pre-supposed safeguards were abandoned.
For example, in Belgium euthanasia was made available to underage individuals and those suffering with mental health issues.
“As Caritas Malta we are a constant witness to how persons struggling with mental health, and persons who may have contemplated suicide, with the appropriate help and support, manage to recover and live fulfilling lives. Any legislation that might eventually open the door for persons with mental health issues to take up the option of assisted suicide is of grave concern and goes against the principle of human dignity.”
ADPD: Consultation document labelled as limited
The Green Party, ADPD, also criticised the public consultation document as being extremely limited, and focusing only on legal procedures and not reflecting on the current state of chronic and terminal illness care, or the suffering experienced by patients.
The party also referred to the need to introduce a biological testament (living will), where a patient gives prior directives to doctors and nurses about acceptable treatments when they’re unconscious or near death. ADPD said it has long been calling for a legal framework for this, as such a mechanism would protect their wishes during difficult moments.
ADPD highlights the serious deficiencies in providing high-quality palliative care in hospitals, elderly care homes and private facilities.
Even with excellent palliative care, there are limits. In some cases, strong opioids or palliative sedation may shorten life but are necessary to avoid extreme pain. ADPD defends the individual’s right to decide what they are willing to endure.
The party highlighted that the government must listen to both patients and professionals, ensure equal access to essential medicines and provide massive investments in end-of-life care and comprehensive palliative services as a right.