Interns Wang Qing, Chen Lei, and The Paper's reporter Ren Wu
"Today, most of us carry in us the fervent hopes of too many people, those who have been seriously ill for many years, those who have stood up for their rights for many years." On March 18, local time, the Spanish House of Representatives passed the euthanasia regulations by a final vote of 202 votes in favor and 141 votes against.
On March 18, local time, the Spanish House of Representatives passed the euthanasia regulations with 202 votes in favor and 141 votes against after the final vote.
After more than a year of deliberations, the regulation was finally approved and will come into force in June. This means that patients suffering from serious illnesses or incurable diseases in Spain will be able to apply for euthanasia or assisted suicide.
This legislation is long overdue for some and finally the comfort of legality for others.
Sofía Malagón, a 59-year-old nurse living in Barcelona, was diagnosed with Parkinson's disease six years ago and, after 25 years at the hospital's ICU, knows what is coming. With the new law, she felt able to choose to die with dignity as she wished.
The discussion of euthanasia in Spain dates back to the 1980s, and looking back at the past four decades, there are persistent struggles of different individuals in the "euthanasia" issue, and there are also close entanglements with political, religious, medical and moral issues, and finally all sectors of society can re-examine the proposition of life and death.
The current global legalization of euthanasia
Death with dignity
A pale-faced man lay on the bed, his limbs atrophied. 30 years ago, he suffered an accident that left him quadriplegic. All he could dispose of was his head, and a cup with a straw stuck in it stood within reach of his head, containing a poisonous solvent enough to kill.
It was January 12, 1998, and the cameras left the last scene in the life of 55-year-old Ramón Sandero.
"When I drink this cup, I will no longer be a slave to shame: a living head on a corpse." Ramon said goodbye to the camera, stating that he didn't need any sympathy, that he had been longing for death for a long time, all based on his own decision. He then drank the poison and for the next 40 minutes or so, he smiled despite his struggles and spitting.
Two months later, the video was broadcast on a Spanish television station, and public opinion was in an uproar. Euthanasia was taboo in Spain at the time, more than two-thirds of Spaniards were Catholic, suicide and euthanasia were undocumental, and under the Spanish penal code at the time, assisted suicide was criminally liable.
As early as 1983, there was a short-lived discussion of euthanasia in Spanish society.
On November 11, 1983, the Spanish newspaper El País published a letter from a reader who hoped to establish a society for the death of dignity in Spain, with the intention of creating a more relaxed public opinion environment and expecting to legalize euthanasia for terminally ill patients by changing the current law. The letterer left his contact details in the national newspaper, and the following year, about 200 people contacted each other in an attempt to jointly create the "Society for the Death of Dignity" (DMD), alias the "Voluntary Euthanasia Society" in Spain.
During the preparations for the association, a 53-year-old leukemia patient Braz appeared and published an article in the newspaper "The State" entitled "Born to Die". Eight years of fighting with illness made him feel that he had become a burden on his family, and he only wanted to have the right to decide on his own death.
These voices are not taken seriously. In November 1984, the Spanish Ministry of the Interior rejected the DMD's application for registration on the grounds that its purpose of establishment violated the Medical Ethics Act. Then Interior Minister Barionievo said, "The death penalty is undignified for anyone. ”
Criticism of the Interior Ministry was in a rush, with Le Petité questioning the Workers' Socialist government's attitude toward death in an editorial, denouncing its inadvertent attempt to reform its perception at the administrative level. Under pressure, a month later, the Home Office approved the application for registration of the DMD on December 13.
In 1986, Spain introduced the General Medical Care Law, which clearly stipulates that patients have the right to refuse treatment, and the euthanasia discussion is temporarily closed.
Seven years later, Ramon filed an application for legal euthanasia before the District Court in Barcelona.
Despite the support of DMD members, his request was rejected by the court on the grounds that it was contrary to the penal regulations. Article 143 of the Spanish Penal Code provides for inducement to commit suicide or assisted suicide, which is punishable by a term of imprisonment of two to five years or six to ten years.
Ramon appealed to the Supreme Court, which was rejected, and finally Ramon brought his claim to the European Union Human Rights Commission in the northeastern French city of Strasbourg, but still failed.
As the first case in Spain to publicly demand legal euthanasia, this case revived the civil discussion about euthanasia. Meanwhile, Ramon's demands for euthanasia put himself and his family at the center of public opinion. Some people question ramon because he didn't get enough family love to give up his life, and similar voices have put Ramon's family in an unspeakable situation.
In 1995, through the efforts of Salvador Paniqueire, the first Honorary President of the DMD, Spain supplemented article 143 of the Penal Code on assisted suicide: if the victim suffers a serious terminal illness and explicitly requests help, the assistor may reduce his sentence as appropriate.
Even so, everything was far from what Ramon wanted.
In 1996, after a failed last appeal, Ramon was disillusioned with legal euthanasia, saying he was left alone in legal punishment, doctoral authority and death taboos.
The following year, Ramon began planning his own death.
The deep sea is speechless
On August 23, 1968, a hangover Ramon Sandeudro wandered on Furnas Beach, not far from home. The 25-year-old grew up in a coastal town in galicia in northern Spain, and at the age of 22 traveled the world with merchant ships, and to him the sea was as familiar as home.
Little by little, the sun is moving overhead, and the sea is receding tide. Ramon was hot and dry. The alcohol obscured his judgment, the waves sounded, and he leapt down from the rocks.
When he woke up, he found that his limbs could not move. Doctors ruled Ramon paralyzed from the neck down. After being discharged from the hospital, Ramon moved out of his apartment and lived with his parents and brother and sister-in-law.
Life becomes cramped. The windowed bed on the second floor was All ramon's activity space, and in order for Ramon to read, his father and nephew made a reader, and Ramon lay on the bed, biting a wooden stick from time to time to turn over books or write poems.
Since Ramon's public declaration that he wished to be happy, many people came to contact him, and some people wrote to him that they shared his illness, but many more expressed their incomprehension. After reading his report, a girl from a cannery, Ramona Mannello, rode to Ramon's home to persuade him not to die alone. Most of the time, Ramon just listened gently to others, and when it came to euthanasia, he would not give in. During the argument, Ramon confided in her about his mental anguish.
For Ramon, no matter how much kindness he accepts, he is always a living dead disguised in disguise, and the moonlight, flowers and love are all outside him, "How can I talk about love when I am dying?" ...... What could be more absurd than hearing a corpse speak? Speak warmly like a human being, but do not know hot and cold, neither happiness nor pain. Ramon believes that such a situation is not life. Because of his quadriplegia, he could not commit suicide, and for the dignity of life, he always tried to find someone to assist suicide.
At the end of 1997, in order not to drag his relatives down, Ramon moved away from his home and lived alone in an apartment twenty-five kilometers away from his home. Unable to move, he needs the help of someone else to place the drug where he can touch it.
This step was cut into eleven movements, and each friend completed an isolated action so that no one would be sentenced for helping him.
Ramon's death is not the end.
In March of the following year, the public video drew outrage from the Roman Catholic Church, and police detained his friend Ramona on suspicion of assisted suicide, but since news of Ramon's death, more than 3,000 people have signed petitions claiming to have assisted Ramón Sandero in his death. Talk shows and newspapers of all kinds were rife with discussions about assisted suicide, and finally LaMona was released due to insufficient evidence.
Ramon's death turned the tide of public discussion about euthanasia, and in March 1998, the labour and social parties that lost the election proposed a bill to legalize assisted suicide, which was rejected by the Spanish parliament, but the BJP government agreed to refer the issue to the Senate and proposed the establishment of a committee to discuss it.
In 2002, Spain introduced the Patient Autonomy Act, which regulates the individual rights of patients in their living wills, and in certain circumstances, patients can refuse to receive medical services.
In 2001 and 2004, tv series and movies based on Ramon's story were broadcast. Director Amenaba said that Ramon's own story is legendary enough that all he has to do is understand and represent him as much as possible, and the film "Deep Sleep" won the 2004 Academy Award for Best Foreign Language Film.
"Deep Sleep" film
In the same year, josé Luis Rodríguez Zapatero, then chairman of the Workers' Socialist Party, proposed in his prime ministerial campaign that "we will strive to establish a committee in Parliament dedicated to the development of euthanasia and death with dignity and to promote the possibility of palliative care." Since then, Ramon's story has completely expanded the public opinion on euthanasia in Spain.
"Doctor Death"
On the one hand, patients represented by Ramon are actively seeking the possibility of euthanasia; on the other hand, doctors represented by Louis Montes are trying to push aside the strong boundaries that hinder death with dignity.
Doctor Montes was dubbed the "Doctor of Death" by the opposition. He has been anonymously accused of sedative injections while serving in the emergency room at Vero Ochoa Hospital, and nine times the mortality rate is three times higher than in other hospitals.
Dr. Louis was soon removed, but he insisted he had given his patients the dignity to die, "only because of the prejudice and incompetence of many doctors, people had to suffer for hours or even days more." ”
In the absence of legalization of euthanasia, Lewis et al. took another approach, not to prolong the life of patients during painful treatment, but to give them palliative treatment with sedatives, to treat near-death as a normal process, without accelerating or delaying death, which was recognized by the Scientific Association.
Falina, president of the Official Faculty of Physicians of Madrid, said that the above-mentioned hospital emergency room team submitted a study of palliative care to the ethics committee of the Getafe Hospital in 2003, and the hospital's sedative management of terminally ill patients was approved. Moreover, the treatment carried out in the emergency room obtained the "informed consent" of the patient's family.
In January 2008, the court concluded its investigation into the case, finding that the patient's death was not necessarily linked to sedative use.
After several similar cases of sedative palliative care, since 2010, several regions in Spain have successively enacted the Law on the Autonomy of Death with Dignity – respecting the wishes of patients, protecting human rights in the process of death, and supporting palliative care. In 2017, catalonia called on Congress to "decriminalize" euthanasia in an attempt to push for changes in Spanish criminal law with the power of the regional parliament.
Despite being called the "doctor of death," Louis has been campaigning for "life." In 2009, he became chairman of the DMD, where he felt that "medicine must prevent suffering and ensure the quality of death." Life is a natural right, and a sober adult should be able to make his own decisions about it. ”
In 2018, Dr. Louis, 69, died in a car accident while driving to a DMD conference.
Thirty years of struggle
The doctor's push has given the public some hope, and patients are also making continuous efforts for their "right to die". In 2019, a video of a death circulating online sparked a heated discussion.
In the video, a light green plastic straw is across the center. At one end of the straw, in a pure glass, contained a poisonous solution as clear as water; at the other end, an old woman with short hair and thin hair quietly leaned on the bed, pillowing the quilt that her husband had raised for her. The disease eroded her body, making her limbs unable to move, and from her neck to her arms, she could see the bulging veins under her skin. At this point, her eyes were closed and she would never wake up again.
Maria José Carrasco has been looking forward to this day for a long time, she is 61 years old, has been plagued by multiple sclerosis (MS) for 30 years, and her hands and feet are no longer freely controlled. She wanted to leave with dignity. On April 3, 2019, with the help of her husband Hernandez, she finally realized her right to die.
At first, she found herself shaking her hands when she signed, painted, and played the piano; watched tv ghosting; she couldn't feel her feet... After the diagnosis, she felt worse and worse, no longer going to see friends, no longer going out, quitting her job in the court. One day, Hernandez came home from work and, as usual, stepped into the apartment shouting his wife's name. But this time, there was no response and the room was eerily quiet.
He hurried into the room, and Maria was surrounded by empty pill bottles, unconscious. He dragged her out of bed, and her weak body "slammed" to the ground. "I dragged her to the bathroom and stuck my finger in her throat," Maria spat out a lump of pills. When she woke up, her husband told her that although he could not stop her from committing suicide, he would "make every effort to prove that she had a reason to continue living.".
He worked less time with his wife, bought hundreds of movie discs to watch with her, and spent weekends with her to go picnics and enjoy nature. But none of this could resist the deterioration of Maria's condition. In response to his wife's situation, Hernandez renovated the apartment for her, installing handles on the wall so that she could carry her to the kitchen; he modified the bathroom to make it easier for his wife to wash, "She doesn't have a high quality of life, but I think she can still keep going." ”
He retired early and struggled to take care of his wife, washing her and applying cream to her. But sometimes, the sound of a wheelchair crunching, the wife's soft grunting, the sound of pills colliding with a pill bottle, these sounds that are getting closer and closer to death make Hernandez a little confused, does the wife want to continue her life? Or is he selfishly forcing his wife to keep living? They discussed euthanasia, even though it was not yet legal in Spain.
Maria's condition has deteriorated to the point where she can't use her hands, and it was 2018, when she collapsed in a wheelchair, as if she were deeply bound by a tight coat and unable to move, almost difficult to see, hear, and sometimes even swallow or talk. She was once again ready for death. That year, Spain's parliament agreed to debate the euthanasia proposal drafted by the Workers' Socialist Party, which gave hope to the couple, but months later, the bill was still blocked by the Conservatives.
Every day of waiting was an ordeal for Maria.
The couple began planning to record a video to bring more attention to the status of patients applying for euthanasia, and they wanted to facilitate further debate and passage of the euthanasia bill. Maria fears that her husband will be at risk of being prosecuted, but Hernandez has made up his mind to help his wife get rid of the pain that has plagued her for years, and decides to record everything that happened with video.
Under camera, Hernandez seriously asks his wife, "Do you want assisted suicide?" ”
Wife: "The sooner the better.". At that time, she was like Ramon more than twenty years ago, lying in a wheelchair unable to move, and the only thing that made people see life in her whole body was her head and the determined eyes. Everything is ready. A hug, a silence, leaving one alone.
Hernandez did not hide these actions in the slightest, he turned himself in to the police, released the video to the media, "we hope this matter will shine a light in the field of euthanasia topics", but at the same time, he himself was sent to the gender violence court, "People who know me and Maria know that we have everything in our marriage, except domestic violence." ”
1 million signatures
Hearing about Hernandez's accusations, "I was as angry and helpless as I was when I got that phone call more than a decade ago. Dr. Holman said. In 2005, he became the first doctor in Spain to be charged with euthanasia for suicide by helping a terminally ill elderly man commit suicide.
"He took care of his wife for so many years, watched his lover die with his own heart, and his assistance was a kind of love." Dr. Holman wrote on the change.org that he was eager to defend Hernandez from being accused and from "rebuilding his life in ten years" like himself.
Dr. Holman is not alone in making a statement in the form of a petition.
Marcos, who has suffered from sclerosis for a decade, wrote the slogan on the petition network, "I love life, respect life, and enjoy my past life." But he was bedridden for four years, enduring a pain that even morphine could not suppress... I want to rest, I don't want to be tormented by pain anymore. He left the world three months later, but his widow is still fighting for signatures for his petition to legalise euthanasia.
"She wants to die when she's unconscious, not to sustain herself in pain and amnesia." But the reality was that he watched his wife's tears run down his face, but he couldn't obey her wishes. Turkma Lorent's wife has been suffering from Alzheimer's disease for 12 years.
During the years when her wife was in the late stages of her illness, she could not take care of herself. Turkma watched his lover cry and make uncomfortable gestures, but she couldn't help herself, only felt intense helplessness.
"Isn't death also part of life?" Other people have the right to have their lives respected, why should my wife want to end her life and this right cannot be respected? He asked in the petition. His petition hoped for the legalization of euthanasia, and his wife died the same year, not waiting for the day the statute was passed.
The petition launched by Holman, Marcos and Turkma received a flood of responses online. On 12 July 2019, 1 million signatures collected from the three petitions were submitted to the Spanish parliament for legal changes to euthanasia.
It's the end, it's the beginning
Popular support for euthanasia has increased year on year, reaching 87% in 2019.
In early 2021, a draft euthanasia law was presented to the Congress. Popular support, partisan push, Parliament agreed to send the draft euthanasia law to the amendment stage.
Sign in the hands of euthanasia supporters: the option to live a painful death. Spanish newspaper El País
During the amendment phase, disputes emerged. The Spanish Church considers the euthanasia bill to be a political action that could create moral problems when legalized, and there are similar concerns among members of the Vox party, Spain's far-right party, "this law is equivalent to signing the death penalty for the weakest." The opposition People's Party (PP) argues that this major social change has not been fully debated publicly. There are also those in the medical community who believe that the new law is contrary to the professional ethics of doctors to save lives and help the injured.
On March 18, 2021, local time, in Madrid, Spain, demonstrators opposing euthanasia protested outside the Spanish parliament.
In the eyes of the supporters of the bill, the legalization of euthanasia means that the right to choose the method of death is returned to the individual, and the bill also provides for corresponding enforcement supervision measures. Those with terminally ill diseases continue to wait.
On 17 December 2020, after much debate, the Spanish Parliament passed the Euthanasia Act. On March 18, the Spanish House of Representatives passed the euthanasia regulations.
Sophia, a 59-year-old nurse who was diagnosed with Parkinson's six years ago, has made her 25 years of experience in the hospital's ICU clear about what lies ahead.
On March 9, 2021, local time, in Barcelona, Spain, 60-year-old nurse Sofia Malagon, who suffered from Parkinson's disease, was interviewed at home. People's Vision Diagram
"I'm worried about dying slowly and living very badly," said Sophia, who has a master's degree in bioethics and has been actively working towards legalizing euthanasia. "Drugs should be used not only for treatment, but also for avoiding pain." The adoption of the new law is progressive for her, but she is not satisfied with it, because the law stipulates that doctors from the country's health department still have the right to raise personal objections to the choice of euthanasia of patients.
"We won the battle, but now there is a war that needs to be fought." Sophia said.
Jessus, an 88-year-old patient with laryngeal cancer, has similar concerns with Sophia, fearing that euthanasia will only be allowed when the pain is unbearable.
On March 2, 2021, local time, in Barcelona, Spain, 88-year-old Jesus Blasco was suffering from throat cancer and looked out through the window of his apartment.
After undergoing surgery for laryngeal cancer, he said he wanted to die. He spent five months in the hospital, making a living on his esophagus, and doctors predicted that he would no longer be able to eat and drink normally for the rest of his life. Jessus said he would consider euthanasia again if his health deteriorated. "Who can decide if my pain is unbearable? Priests, popes, politicians? It's up to me. He said.
After losing his wife, Hernandez is still awaiting further sentencing in the case. His and Maria's small home was filled with calligraphy and paintings, many of which were written by Maria, and wheelchairs were quietly placed in the home. "I won't change the layout of my home until euthanasia is legalized, and that's when my grief comes to an end." Until then, in the days without her, he had just lived and was troubled.
Editor-in-Charge: Peng Wei
Proofreader: Liu Wei