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HEALTH

What you need to know about Spain’s proposed euthanasia laws

Spain's Socialist party are trying to push through a bill that effectively decriminalises euthanasia, proposing that any person suffering a serious debilitating or incurable illness may be helped to die if they wish, in order to avoid intolerable suffering.

What you need to know about Spain's proposed euthanasia laws
Could Spain become the fourth country in the European Union to legalise euthanasia? Photo: AFP

What are the current laws surrounding assisted suicide in Spain?

The new legislation seeks to modify part of article 143 of Spain's penal code, which currently bans anyone from causing or cooperating with the death of another person suffering from “a serious, terminal illness or one that causes serious, permanent ailments that are difficult to endure”.

The bill would make it legal for a person to cause or help cause the “reliable, peaceful, painless death” of another suffering from those problems if they “specifically, freely and unequivocally” ask for it.

Currently in Spain, people with incurable diseases only have the option to refuse treatment. 

READ MORE:  Is Spain on the verge of legalising euthanasia?

The right to a good death

The preamble of the bill which is currently being debated in Spain's lower parliament enshrines what is described as the “right to a good death” and discusses both euthanasia and assisted suicide.

The first term refers to an instance where active steps are taken to end someone's life, but the fatal act is carried out by someone else, such as a doctor.

And assisted suicide is when someone takes their own life but is assisted by somebody else. Rather than a doctor carrying out the fatal act, they themselves do so.

Who will have the right to request euthanasia?

The proposed bill sets out that all Spanish citizens or those resident in Spain will have the right to request a dignified death if they are suffering from “a serious and incurable disease” or a “chronic and severe disability” that makes life “unbearable”.

In order to qualify, the sufferer must have “in writing all the information about their condition” and “the different options available going forward including what palliative care can be offered”.

How is the request made?

The bill outlines that a first request to die must be made in writing, without pressure, and must be repeated 15 days later.

Within 48 hours of the second request being made, a doctor will assess the patient and provide “both verbally and in writing” details of the “diagnosis, possible treatment and expected results and options for palliative care”.

A further 24 hours after that consultation, the patient must repeat his desire to continue with his request for euthanasia and then the case is passed to a second doctor who has ten days to assess and determine whether the patient meets the criteria.

If the second doctor also agrees that the criteria is met, then the case is reviewed by a special commission to finally determine whether euthanasia is an option.

Those who are incapacitated can make provisions to express their wishes.

So doctors have to approve the right to die then?

The proposed bill is very careful to state that doctors do not approve the request for euthanasia but rather determine that the patient's condition meets the medical requirements set out in law – determining that the condition is “serious and incurable” or a “chronic disability”.

How will euthanasia take place?

Once consent is granted it is the patient who decides in what form the “help to die” is given, either euthanasia or assisted suicide: either the direct administration of a fatal dose of medication by a healthcare professional, or a prescription for such a dose to be taken by the patient themselves either at home or in a medical centre.

Can doctors refuse to carry out euthanasia?

If the patient meets the criteria to seek euthanasia then they are legally bound to say so, but medical professionals will be able to refuse to carry out euthanasia.

The new bill expressly states the right to conscientious objection and outlines that healthcare professionals who are opposed to euthanasia must state so in advance and in writing to be included in a register of those who object to the practice.

What if the patient is too incapacitated to state their desire for euthanasia?

This too is covered in the bill. Those who have expressed their desire legally in a “living will” when they were able to, can have the request made for them when their condition worsens to the point that they can no longer communicate.

How will the death be recorded?

The bill states that those whose death is facilitated through euthanasia will be recorded as “natural death”.

Do Spaniards support euthanasia?

The most recent poll, for Metroscopia last year, found 89 percent of Spaniards supported euthanasia for people with incurable conditions.

This is the third time in a year that the government of Prime Minister Pedro Sanchez has attempted to introduce the bill into Spain's parliament. But he now has the backing of Podemos as part of the left-wing coalition formed in January.

Who is opposed?

The Spanish Episcopal Conference of Catholic Bishops has consistently opposed any change to the law which twice failed to be passed.

“Actively provoking a death is never a good solution,” said Luis Arguello, secretary-general of the Episcopal Conference, which groups Spain's leading bishops.

The church stance is also supported by parties on the right including the Popular Party (PP) and Vox. Both parties are vehemently opposed to euthanasia decriminalisation and believe such situations should be managed with palliative care instead.

How does the bill compare to other legislation in countries that allow euthanasia?

Prime Minister Pedro Sanchez has long promised to make Spain the fourth country in the European Union to legalise euthanasia after Belgium, Luxembourg and the Netherlands. In Switzerland assisted suicide is allowed.

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HEALTH

How Spain could stamp out smoking

A fifth of Spain's population smokes on a daily basis. With such high numbers, here's how the country's pulmonologists propose to get smokers to quit.

Spain plans to get people to quit smoking
How Spain plans to get people to stop smoking. Photo: Khalil MAZRAAWI / AFP

For many outsiders, Spain is a nation of smokers. 

The stats from Spain’s Ministry of Health show that 23.3 percent of men smoke every day in Spain, compared with 16.4 percent of women.

For both males and females, the highest number of smokers are aged between 25 and 34, meaning that it’s the younger population who are smoking slightly more than the older generations. 

Spain’s pulmonologists are now pushing for the country’s tobacco laws to be tightened, claiming that reform is needed after the last legislation was approved a decade ago.

READ ALSO: Spain warns against smoking and vaping in public to avoid Covid infections

Why is smoking such a problem in Spain and what is being done about it?

The latest stats from the Spanish Ministry of Health show that lung cancer, often caused by smoking, is the third most frequently diagnosed cancer in Spain, with 29,549 cases diagnosed so far in 2021.

Given these high figures Spain’s Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) has proposed five measures to help get people to stop smoking.

SEPAR points out that every time anti-smoking legislation is reformed and things for smokers made more difficult, the prevalence of smoking decreases.  

Smoking on terraces was banned in some regions during the pandemic. Photo: CRISTINA QUICLER / AFP
  • Price of tobacco to rise in 2022

The first point on their list is to raise the price of tobacco, which must cover all forms, from cigarettes to cigars, through to rolling tobacco, and electronic cigarettes.  

This first measure may soon become a reality as the Spanish government has already predicted that the price of tobacco will rise in 2022, after several years of stagnation.  

It is expected that tobacco will be responsible for almost a third of all special taxes received in 2022, equating to €21.8 billion.

According to the World Health Organization (WHO), “cheap tobacco” in Spain guarantees “a percentage of smokers above 30 percent”.

In Spain, the price of a pack of tobacco is around €5, which is much cheaper than in other countries. In Australia for example, a pack of tobacco costs around €22, and in the United Kingdom and France, each pack of tobacco costs around €12.4 and €10.5, respectively.

According to Dr. Carlos A. Jiménez Ruiz, pulmonologist and president of the society, the current anti-smoking law has “some deficiencies” that need to be addressed in order to develop legislation that is more effective and efficient, especially with regard to the prevention of tobacco consumption in young people, but also in helping smokers to stop smoking and in protecting the health of non-smokers. 

READ ALSO – Maps: Which beaches in Spain have banned smoking?

Besides increasing the cost of tobacco SEPAR proposes four other measures to get Spain to quit smoking. These include:

  • Banning the consumption of tobacco in public spaces, even outdoors
    During the pandemic, several regions approved a regulation to prohibit smoking on terraces. SEPAR proposes that smoking be prohibited not only in spaces such as terraces but also in sports stadiums, beaches, parks and bullrings, and that fines should be imposed for those who do not comply.

  • Establish generic packaging
    SEPAR also wants Spain to introduce generic packaging, which means no logos and images of the tobacco companies. This measure has also proven to lower the sales of tobacco in countries where it has been implemented, such as Australia and New Zealand. According to the latest statistics from the Australian National Drug Strategy Household Survey around 11.6 percent of adults in Australia smoke daily. 

  • The regulation of other smoking devices
    Despite the fact that all products that burn tobacco such as cigarettes are already regulated, SEPAR believes that it is also necessary to regulate the sale, consumption and advertising of electronic cigarettes. This is because e-cigarettes have become particularly popular among young people. 

  • Promote help for those seeking to quit smoking
    The last proposal is the creation and development of special units in public health departments to help people to stop smoking and to put more funds towards these programmes. 

How does Spain compare with other European countries when it comes to smoking?

According to the Organisation for Economic Cooperation and Development (OECD), while Spain does have a high number of smokers there are still several European countries that have more. The European countries with the highest number of smokers are Greece, Bulgaria and Hungary.

The latest European survey from 2020 shows that 42 percent of Greeks claim to be smokers, which is only slightly above Spain. 

On the other side, the European countries with the lowest number of smokers are mainly Nordic countries, such as Sweden, Finland, Iceland and Norway.

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