The introduction of physician-assisted suicide and euthanasia in Malta would further undermine the provision of palliative care services which are currently inadequate, and would contradict the ongoing national efforts to prevent suicide. Instead, greater investment must be directed towards strengthening palliative care and avoiding overtreatment.
These are among the key concerns raised by a multidisciplinary group of academics from the University of Malta in a position paper in response to the consultation document published last month by the Maltese Government on the introduction of “assisted voluntary euthanasia”.
The academics note that while the Government’s proposal is titled “assisted voluntary euthanasia,” it in fact encompasses both physician-assisted suicide —where individuals themselves carry out the final act leading to their death— and euthanasia, where the final act is performed by another person. The academics argue that the introduction of physician-assisted suicide and euthanasia is unjustified. Effective palliative care services (meaning the medical, emotional social and spiritual support provided to patients at the end of their life, and to their relatives) can adequately address pain and suffering if current deficiencies are properly addressed.
The academics further argue that legalising physician-assisted suicide and euthanasia would endanger vulnerable individuals, particularly those who may perceive themselves as a burden on others. People with limited financial resources and inadequate social support could feel pressured into choosing death over life. In such cases, choosing to die would eventually lead to a duty to die.
They also contend that the introduction of such a law would defeat the fundamental right to life, which laws have the responsibility of protecting. Emphasis must be put, instead on recognising the moral and legal right of patients to refrain from receiving medical treatment when this is futile, and to avoid overtreatment that would only lead to prolonging death unnecessarily. The academics also encourage broader education and clear guidelines on the use of palliative sedation.
Responding to the claims that the introduction of physician-assisted suicide and euthanasia is the affirmation of self-determination or autonomy, the academics insist that autonomy is never absolute. Persons are always part of a broader network of relationships. Moreover, the academics raise concerns that the right to conscientious objection is weakened when professionals are required to refer patients to others who are willing to provide physician-assisted suicide or euthanasia.
Additional concern is also raised over the proposal to classify deaths by euthanasia as natural deaths, a measure that would erode transparency and hinder accountability within the entire legislative system.
The document concludes with several recommendations aimed at improving end-of-life care in Malta. These include the implementation of the National Palliative Care Strategy for Malta 2025-2035; legal protections honouring patients’ rights to refuse treatment; training medical professionals on this matter; public awareness initiatives to enhance the understanding of palliative care; and the promotion of voluntary care programmes to foster solidarity and a renewed culture of compassion within Maltese society.
The position paper, endorsed by 135 academics, will be also submitted to Members of Parliament.