Information on the current situation
In collaboration with LovinMalta, the Malta Humanist Association created this video to explain the Humanist view on assisted dying.
Assisted Dying in Malta
The term ‘Assisted Dying’ covers both active euthanasia and assisted suicide:
• active euthanasia is the administration of a lethal drug to a patient by a doctor, because the patient is terminally ill or incurably suffering. Voluntary active euthanasia requires the patient’s consent;
• assisted suicide is the intentional provision to a person, at their request, of the knowledge, means, or both, required to commit suicide. Physician-assisted suicide involves such actions by a doctor. We have found no jurisdictions where assisted suicide by other than a doctor is legal when physician-assisted suicide is not. By contrast, withholding or withdrawal of medical treatment, and palliative sedation (sometimes collectively called passive euthanasia) are not generally viewed as assisted dying, but as ways to make the patient as comfortable as possible, avoiding fruitless interventions and suffering, and allowing them to die, rather than causing them to.
What is the current legal situation in Malta?
• active euthanasia is illegal, and assisting a suicide is a crime punishable by up to 12 years in prison;
• palliative sedation and withdrawal of treatment is legal;
• patients have the right to refuse treatment, but must be conscious to do so;
• there is no law regulating “living wills” (or “advance directives”), which would enable people to state their wishes to be respected if, for example, they are no longer able to communicate or make decisions about treatment. (Download a sample here, but note that such documents are not currently legally enforceable.);
• euthanasia, assisted suicide, and legally enforceable living wills are not considered human rights under international treaties, nor by the European Court of Human Rights (1)
How does society feel about it?
According to a 2021 study, a majority in Malta (52.6%) support the right to legally end one’s life if terminally ill and suffering (2), reflecting a shift in public opinion over recent years, as found in earlier polls (3). The study also found that 88% believe the subject should be discussed on a national scale.
Among Maltese youth – including law and medicine students – euthanasia is becoming significantly more acceptable than among older generations. A 2016 Għaqda Studenti tal-Liġi (Law Students Malta) survey showed approval for euthanasia among law students at 69% (4). Another poll the same year showed that 65.1% of those aged 18-34 agreed that the state should allow terminally ill people the right to end their life (only 35.2% above the age of 55 agreed) (5).
How do doctors feel about it?
In a 2016 survey of 350 doctors, over 90% said they were against euthanasia, but just over 50% agreed with intensifying analgesia with the possibility of hastening death, and 32.1% had withdrawn or withheld treatment to terminally ill patients. 11.9% had faced requests for euthanasia (6). The survey concluded that “doctors need more guidelines, both legal and moral about this subject. In the absence of this, religion and life philosophy were being used as a guide in this difficult aspect of practicing their profession” (7). Such calls for more guidance and legal certainty for the medical profession have continued (8).
There was a difference in perspective between those doctors polled in 2016, and doctors then in the making. The Malta Health Student Association said “the health care system. . .start to seriously consider the legalisation of Euthanasia as it is undoubtedly an answer to some of our critically-ill patients” (9).
Where do political parties in Malta stand?
We can find no definitive recent statements on parties’ agreed positions, but it seems that, so far, no party officially supports the legalisation of any form of assisted dying.
In 2021, when PL Prime Minister Robert Abela launched a discussion document on Labour policy, “voluntary euthanasia for people with a terminal illness” was included as a topic for national debate (10). After New Zealand voted in 2020 to legalise euthanasia, PL deputy leader Daniel Micallef said he would be campaigning for it (11). And according to a non-exhaustive report in 2020, some individual PL MPs would support it (12). In 2017, PL youth branch Forum Żgħazagħ Laburisti said it favoured legalisation of euthanasia (13).
In 2016, Alternattiva Demokratika (now merged into the APDP) said “whilst AD does not agree with the termination of life through euthanasia, it is in favour of the drawing up of ‘living wills’ or ‘biological wills’” (14).
In 2017 the PN opposed legalisation of euthanasia (15). In 2020 PN party leader Bernard Grech said he was against it (16).
Of course, as was the case in the divorce debate, and currently in the abortion debate, there are those who do not follow the stand taken by the political party they usually vote for.
A Humanist View
Humanists generally agree that our lives are our own, and we should be free to decide our own destiny and life-experience, provided that does not result in harm to others. The Malta Humanist Association supports bodily autonomy, meaning that people should have the right to choose the manner and timing of their own death – although strict monitoring, regulation and safeguards are necessary to avoid any abuse or uncertainty
A general prohibition on assisted dying binds all, patients and medical professionals alike, to one view. Voluntary assisted dying cannot, by definition, be imposed on patients who disagree with it. But legalisation, for those who agree, would enable people, and the medical profession, to act on their own conscience.
There has so far been little, if any, evidence of abuse in countries where assisted dying is legal (17). And future improvements in palliative care are not the answer for those who are now terminally ill or incurably suffering, and have a positive wish that their body should not be kept functioning when they are without independence, quality of life, and dignity.
Assisted dying in the rest of the world (at November 2021)
Legislation, and criteria, vary, but forms of assisted dying are legal in a number of countries:
• Physician Assisted Suicide: Parts of Australia; Austria; Belgium; Canada; Germany; Italy [in principle, but with no legal framework]; Luxembourg; The Netherlands; New Zealand; Spain; and Switzerland.
• Voluntary Active Euthanasia: Austria; Belgium; Canada; Germany, Luxembourg; New Zealand; the Netherlands; Spain; and Switzerland.
Assisted dying services in the EU for Maltese residents (at November 2021)
We have not found any EU jurisdictions where any form of assisted dying is effectively available to non-residents. This is why we would support the establishment of bilateral agreements with other countries to enable Maltese residents to make use of assisted dying clinics abroad.
(17) https://www.economist.com/leaders/2021/11/13/the-welcome-spread-of-assisted-dying; https://www.gov.je/SiteCollectionDocuments/Caring%20and%20support/P%20Presentation%201%20Humanists%20UK%20Andrew%20Copson.pdf