ECHR: Hungary refusal of medically assisted death does not violate human rights

ECHR: Hungary refusal of medically assisted death does not violate human rights

The European Court of Human Rights ruled Thursday that Hungarian authorities’ refusal of a citizen’s request to end his life by physician-assisted death doesn’t violate the European Convention on Human Rights.

The case started with Daniel Karsai’s request to have access to medical suicide after being diagnosed with an incurable motor neurone disease that causes the gradual loss of voluntary control of muscles, including respiratory muscles. This eventually leads to death, which occurs within three to five years, because of respiratory muscles paralysis. Karsai asked national authorities to have access to medically assisted suicide before reaching an advanced stage of the disease. However, Hungarian law criminalizes helping someone to end their life and anyone who offers assistance in Hungary or abroad could face criminal prosecution.

Karsai filed a complaint to the European Court of Human Rights in which he claimed that the impossibility of ending his life in Hungary or abroad despite being “terminally ill and suffering” is discriminatory and violates Article 14, and Article 8, of the European Convention on Human Rights. He argued that he was discriminated against compared to terminally ill patients undertaking life-sustaining treatments because the latter have the right, according to Hungarian law, to ask for the withdrawal of their medical treatment.

In its ruling, the European court acknowledged that Hungarian authorities have full discretion to assess whether physician-assisted death should be allowed or not and they did not “overstep” their discretion when they rejected a citizen’s demand to have access to medical suicide abroad. The court highlighted the importance of taking into account the “wider social implications and the risks of abuse and error” linked to medical suicide before deciding to provide access to it. By rejecting Karsai’s demand, the court found that Hungarian authorities managed to establish “a fair balance” between Karsai’s desire to end his life through physician-assisted death and “the legitimate aims” behind the Hungarian legislation prohibiting medical suicide.

The European court also added that access to high-quality palliative care such as palliative sedation, compliant with the European Association of Palliative Care‘s recommendations, can provide relief to suffering patients in the same situation as Karsai.  However, the latter refused to undertake palliative care and did not prove that such care was not available for him. According to the court, Karsai’s “personal preference to forego otherwise appropriate and available procedures could not in itself require the authorities to provide alternative solutions, let alone to legalise physician-assisted death,” hence there was no violation of the Article 8’s protections.

As for the violation of Article 14 claim, the court found that there’s no discrimination between Karsai and terminally ill patients because the latter’s right to refuse or withdraw medical treatment is related to the right to free and informed consent, not the right to assisted suicide. While the first is recognized by the EU, the second is not, which is why the difference in treatment is justified.

The court pointed out in its decision that despite the growing trend of legalization of medical suicide within the EU, many European states still prohibit both euthanasia and medically assisted suicide. Nevertheless, the court recalled that the European Convention on Human Rights should be “interpreted and applied in the light of the present day,” by taking into account both the developments of European societies and the standards of medical ethics.

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