According to the regulations, euthanasia in Ecuador can be performed in hospitals of the National Health System or the patient’s home. These are the requirements.
On Friday, April 12, 2024, the Ministry of Health of Ecuador published in the Official Registry the Regulations of the Procedure for the Application of Euthanasia. With this, the early death method has free rein to be applied in the country. The publication complies with the historic ruling of the Constitutional Court, which legalized death with dignity at the request of Paola Roldán. This regulation has eight chapters, two general provisions, and three transitional provisions that seek to establish clear guidelines to access this procedure. Ecuador is the ninth country in the world in which euthanasia is legal.
In the articles, there are key elements that detail step by step how this intervention is carried out and under what parameters. Among the most important we have:
Types of euthanasia: Euthanasia is understood as the medical procedure to end the life of a person who suffers from a serious and incurable illness or a serious and irreversible bodily injury. Constitutional Court recognizes the right to euthanasia in Ecuador. In the case of Ecuador, and following international standards, this procedure is carried out under the administration of drugs in lethal doses.
Active euthanasia: This contemplates the request of the patient or his legal representative.
Volunteer (avoulntaria) active euthanasia: In this case, the patient anticipated his willingness to undergo euthanasia and the request is made by his legal representative.
Voluntary (voluntaria) active euthanasia: this is the most direct procedure, that is, when there is the express and current request of the patient himself.
Requirements to request euthanasia: The Regulation sets out nine items that must be considered to access the procedures, both via active voluntary or volunteer means.
Between them we have:
- Be of age.
- Be Ecuadorian or resident foreigner.
- Application for the application of Voluntary Active Euthanasia.
- Medical report that details aspects such as definitive diagnosis, disease evolution, treatments, among others.
- Request for ratification or revocation of the application of the procedure. In the case of Voluntary Active Euthanasia, requirements such as:
- Notarized advance directive or living will documents.
- Application for the application of Voluntary Active Euthanasia.
- Certification of the patient’s current inability to make decisions.
Request for Euthanasia: Once the requirements have been met, the request must be submitted to the Technical Secretariat of the Interdisciplinary Committee to resolve the Application of Voluntary and Voluntary Active Euthanasia. This Committee will exist in each institution of the Public Health Network of Ecuador. If the person who wishes to access euthanasia does not have any type of Social Security, their request must be submitted to Districts or Zonal Health Coordination of the Ministry of Public Health.
The deadline to resolve any request that reaches the Technical Secretariat is two days. If acceptance of the procedure is received, the interested party has 10 days to ratify or revoke the request. If you do not do so, the procedure will be archived.
Conflict of interest and conscientious objection: As indicated in the Regulation, the entity most responsible for whether or not a patient agrees to euthanasia in Ecuador is the Interdisciplinary Committee. This is made up of specialist doctors, a clinical psychologist, a psychiatrist, a lawyer, a bioethicist, a social worker, and a representative of civil society. These members may reject their appointment in the event that there is a conflict of interest with the patient or legal representative or if they exercise their right to conscientious objection. Once this Committee is formed, it has 10 days to issue a resolution on a case.
Application of euthanasia: If there is a favorable resolution from the Interdisciplinary Committee, the interested party can access the application of Voluntary and Voluntary Active Euthanasia, as the case may be. Additionally, an informed consent document signed by the patient, or their legal representative will be required.
Once that is resolved, the euthanasia procedure can be carried out in the establishments of the National Health System or the patient’s home if that is their wish. At least one doctor and one nurse must participate in the execution. These professionals must use drugs that guarantee that the procedure is short and accurate, with simple and lethal administration. It is important to highlight that the patient may revoke his or her consent to undergo the procedure verbally at any time, even before the start of the procedure itself. If the procedure continues, death as a result of the application of euthanasia will be considered a natural death.
Does Alzheime’s disease qualify for Volunteer (avoulntaria) active euthanasia?