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WMA no longer speaks of ‘unethical’ when it comes to euthanasia

In her newly adopted Declaration on Euthanasia and Physician-Assisted Suicidethe World Medical Association (WMA) no longer considers euthanasia as ‘unethical’ and also no longer explicitly condemns medical practice of it. The WMA maintains its firm opposition to euthanasia and suicide assistance. 

The preceding documents

The three preceding documents from the WMA about euthanasia and suicide assistance did declare euthanasia and assisted suicide as unethical and stated that the medical profession should condemn both:

– WMA DECLARATION ON EUTHANASIA (adopted in 1987 and reaffirmed in 2005 and 2015)   
– WMA STATEMENT ON PHYSICIAN-ASSISTED SUICIDE (adopted in 1992, revised in 2005 and reaffirmed in 2015)
– WMA RESOLUTION ON EUTHANASIA (adopted in 2002, reaffirmed with minor revision in 2013) 

These three documents were all rescinded and archived by the 70th WMA General Assembly in Tbilisi this October and all have been replaced by the new WMA Declaration on Euthanasia and Physician-Assisted Suicide, that the WMA calls ‘completely rewritten’. 

The topic of euthanasia and assisted suicide has always been a difficult issue within the WMA. There are a small number of countries in the world where euthanasia and assisted suicide are regulated by law. In addition, there are countries where the discussion about legalization is in full swing. And there are countries where it cannot be discussed. Whatever the laws and rules are: doctors struggle with the issue. And so the WMA regularly pays attention to it. 

However, emotions run high when it comes to this topic. In October 2018, the chairman of the Dutch RDMA said: “When the theme of euthanasia and assisted suicide comes up in our meetings, emotions can run high. I sometimes feel very uncomfortable with that. There are even times that I wonder if we can remain a member of an organization that in fact morally condemns us, Dutch doctors.”   

The Dutch RDMA and the Canadian CMA, both medical associations in a country in which euthanasia and assisted suicide is legal, even left the WMA after a meeting in October 2018. The direct reason for this was the fact that the new chairman of the WMA used texts from others without mentioning this in his inaugural speech on this meeting. However, it is conceivable that the issue of euthanasia also played a role in their decisions to leave the WMA. 

Reaction of the Dutch medical association on the new declaration
For now, the Dutch RDMA is cautiously positive about the recently adopted statement and “sees it as the outcome of a discussion that the RDMA, together with its Canadian sister organization, started a few years ago within the WMA. Although the opposition to euthanasia and assistance with suicide continues to exist within the WMA, the doctors who perform this are no longer (morally) convicted. This is a small but, according to the RDMA, crucial and positive step in the further discussion on this important topic among doctors worldwide”. 

The Canadian Medical Association has not (yet) placed a reaction on her website. 

Reaction of the World Federation of Right to Die Societies 
The World Federation is positively surprised by this new declaration of the WMA. Although the declaration itself is still opposing euthanasia and assisted suicide, the absence of the judgement ‘unethical’ takes away a major argument used by national medical associations and a lot of individual doctors, when opposing legalisation in their countries. The lack of a call to doctors and medical associations to condemn this practice is also positive news for these doctors and medical associations that have other views on this topic. Hopefully they will feel more free now to speak out their own beliefs based on their own experiences.