Colombia is the only country in Latin America in which medical aid in dying is allowed and regulated. Together with the Netherlands, Belgium, Luxembourg and Canada it is also the only country in which not only assisted suicide but also euthanasia is allowed. Typical for Colombia is that the legal criteria are not laid down in a law but in a resolution. The resolution was the result of several lawsuits in the years before, starting in 1997. In 2018 the possibility of euthanasia became also accesible for children. In september 2020, a bill is introduced and discussed in Parliament.
Between 2015 and 2019, euthanasia is been applied only 40 times, according to official records. After 2019 this number increased. Between 2015 and March 2020, there have been 92 euthanasias reported in adults, according to the Colombian Ministry of Health.
In 2015, Resolución número 1216 was created. With this resolution, the Minister of Health declares that only adults are eligible for euthanasia who are in the terminal phase of life. If the patient has lost consciousness, then the family must demonstrate the euthanasia desire by filming or writing down the patient’s wish. If the patient is eligible for euthanasia and the doctor refuses, a health authority will help them find an alternative doctor.
“We have not had a big national debate about this, and I’m not very happy about it,” says a former Colombian health minister. “We need a public debate: We are not Belgium or Holland – this is at odds with people’s beliefs and mode of thought.” It would be good for a team of bioethcists to study the situation in Colombia with the same rigour as they have in Belgium, the Netherlands, or Canada.
On March 9, 2018, the Department of Health and Social Protection issued Resolución número 825/2018. This resolution allowed euthanasia for children over 6, when they have the approval of their parents. The Department explained that before that age children do not understand the idea of their own death. Children between the ages of 7 and 12 can access euthanasia with the approval of their parents. Children between 12 and 14 can access it even if their parents disagree. After 14, no parental involvement is needed, provided that all the requirements for euthanasia are fulfilled.
On August 27, 2019, a draft law to regulate euthanasia was presented to the Congress of the republic Colombia. Although there is already a Resolution, having a law will give peace of mind to the treating doctors, who many times, for not having much regulatory clarity, are afraid to apply this procedure.
The bill provides guidelines for the application of euthanasia, both for patients with end-stage disease and for patients with chronic disease with a high impact on quality of life. A person can rely on the law when one of three conditions is met: that the person has 1) a terminal illness with a prognosis of death, 2) a terminal disease in an advanced state or 3) an incurable disease and that his or her quality of life is affected in a serious way.
With these criteria, the provisions of the Court are expanded. Two more causes are added in order to rely on the law. The Court only opened euthanasia to people who have a terminal disease in an advanced stage. The draft law includes two more situations in which a person can rely on the law: 1) when a person has an incurable disease with a prognosis of death (for example a cancer that is very advanced) and to him/her is told that only palliative care can be done; and 2) when a person has a medical condition that affects his/her quality of life in a serious way (for example someone who is in a quadriplegic state): you do not have a terminal illness, but you have a medical condition that is not going to be replaced and that affects your quality of life. End September 2020 the first debate on this new bill to regulate euthanasia has taken place.