Legal void and ethical ambiguity in end-of-life care

The current medical treatment of suffering patients at the end of life in Slovenia is fraught with legal and ethical uncertainties, particularly concerning the practice known as "treatment with double effect." An analysis suggests that these procedures are inadequately regulated, potentially operating outside the bounds of the law, and are conducted without sufficient public scrutiny, thereby fostering an environment ripe for potential abuses.

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The result of the analysis was that it is poorly regulated legally, as it appears, it can even be illegal, the ethical guideline can be found in the Catechism of the Catholic Church. It is filled with the arbitrariness of doctors, without public control, therefore it is dangerous and a hotbed of possible abuses.

Andrej Bračič, a healthcare professional, has corroborated these concerns, confirming the existence of a legal void and ethical ambiguity within the system. Bračič shares the view that the absence of clear legal frameworks could facilitate the concealment of euthanasia under the guise of treatment with double effect. To address this, Bračič advocates for the normative regulation of treatment with double effect.

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He confirmed that there is a legal vacuum and ethical ambiguity. Like me, he is of the opinion that the lack of legal regulation can enable the concealment of euthanasia under the guise of treatment with double effect.

The author clarifies that the intention is not to claim that a law on voluntary termination of life alone would resolve all anomalies. Instead, similar to Bračič, the proposal is for legislation that decriminalizes medical interventions resulting in a patient's death. Such a law, the author argues, would complement, not replace, a law on voluntary termination of life, as the latter addresses a broader spectrum of health-related suffering beyond just the indications for treatment with double effect.

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As a solution, he proposes normative regulation of treatment with double effect.

The author posits that opposing the law on voluntary termination of life indirectly supports the current unregulated state of affairs. While this law alone cannot establish order, it can serve as a crucial anchor point, providing the motivation and courage needed to enact legislation decriminalizing medical procedures that lead to a patient's death. The article also references the late chairman of the Commission for Medical Ethics, Jože Trontelj, who acknowledged that in a small number of cases, pain and anxiety cannot be adequately managed with standard medication dosages. In such instances, the commission deemed it permissible for a doctor to increase analgesic or sedative dosages, even if it might shorten the patient's life, provided the primary goal is alleviating suffering, not causing death.

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I believe that by reading my article, he got the impression that I advocate that the adoption of the law on assistance in voluntary termination of life (ZPPKŽ) would eliminate almost all anomalies: from the legal and ethical ambiguity of treatment with double effect, the weaknesses of palliative sedation to the arbitrary decision-making of doctors.