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Euthanasia Tourism: Is The E.U. Encouraging Its Growth?

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Euthanasia appears in the news usually as a result of a legal or ethical controversy surrounding the legality or illegality of its application.

Most recently, though, it's getting attention again due to another controversial subject: euthanasia tourism, a strange pairing of words as “tourism’ is typically associated with a joyful experience rather than a voluntary desire to end one's life.

The most general definition of the phenomenon: When a person travels to a country offering euthanasia or assisted suicide as a legal option because the act is forbidden or more restrictive in his or her home country.

Euthanasia tourism can be associated with “medical tourism,” another phenomenon enabled by advances in medical technology, the increase of travel opportunities and the globalization of health care. These factors have opened the doors for consumers to travel across borders or to overseas destinations to get medical treatment.

Among the most popular travel-triggering treatments are cosmetic and dental surgery, cardio and orthopedic surgery, and organ and tissue transplants.

Two recent cases have brought renewed global media attention to euthanasia tourism:

The recent defeats by legislatures in New Mexico and Arkansa of bills to legalize assisted suicide that would have freed doctors to prescribe life-ending drugs to patients wishing to terminate their suffering by taking their lives, and in the words of the Christian Post, “to enable 'suicide tourism,' allowing people from other states to come to New Mexico for assisted suicide.”

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The second case is the uproar in Europe around what has been described as “the ruling by the European Union to encourage euthanasia tourism,” which has propelled fears that Belgium is becoming a popular destination for the practice.

There's a notable increase in the number of patients travelling to Belgium, where “mercy killings” have been legal since 2002, mostly from the other 27 European Union member nations as well as from other continents where euthanasia is barred.

French applications are at the top of the list.

The debate has been reignited by a new element - the legal implications of permitting foreign doctors to come to Belgium to help terminally ill patients end their lives.

“A 2005 E.U. directive allows for medical qualifications to be recognized in another E.U. member state,” explains The Telegraph. “Critics are blaming the law for making euthanasia tourism easier because it allows doctors accompanying a patient to another E.U. country to practice there.”

The European Commission has denied such an interpretation. Although it is legally possible to grant permission to perform euthanasia to a doctor from another E.U. country, just as foreign doctors are allowed to perform certain medical procedures among E.U. countries, they still can face prosecution in their country of origin.

“The European Commission, which drafts E.U. laws, insisted that the responsibility to prevent the practice lay with national governments," The Telegraph noted. "It is up to them to decide whether doctors travelling abroad to perform euthanasia legally had broken the law at home."

A Commission spokeswoman said that “E.U. law does not prevent the receiving member state from checking in cases of doubt and taking the appropriate measures to protect patient safety. Quite the contrary. E.U. rules lay out the respective responsibilities very clearly and tools of administrative cooperation should facilitate detecting and coping with such problems,”

Before Belgium became the so-called “world’s euthanasia capital,” that distinction belonged to Switzerland as the best-known final destination for foreigners in their journey to assisted death. Assisted suicide has been allowed since 1942 and eight right-to-die clinics operate there -Dignitas the most widely-recognized due to various controversies.

Apart from Belgium, euthanasia is legal in two other E.U. countries: the Netherlands, which was the first to legalize assisted suicide and euthanasia, and Luxembourg. (Switzerland is not an EU member state.)

Other countries tacitly allow passive euthanasia, including France, where it is illegal but maintains a “sedate dying” law that was passed in 2016 to let doctors keep terminally ill patients sedated until death.

In Germany assisted suicide is legal but only if a lethal dose is taken with no help from anyone else. 

Canada, Colombia and the Australian state of Victoria are among countries that allow assisted suicide under various restrictions. Oregon was the first US state to legalize assisted suicide in 1997 for terminally ill patients, followed by Washington and Vermont.

“Euthanasia in Belgium is counted as a basic health service, covered by the monthly premium that every citizen pays to his or her insurance company,” explains The Guardian. “But doctors are within their rights not to carry it out. Unique among medical procedures, a successful euthanasia isn’t something you can assess with your patient after the event. A small minority of doctors refuse to perform it for this reason, and others because of religious qualms.”

Patients seeking euthanasia in Belgium must meet with the doctor carrying out the procedure several times over a period of months as a safeguard to ensure the application is voluntary and fulfils the necessary criteria, which includes that the patient's request must be voluntary, well-considered and without outside pressure. The applicant must report unbearable physical or psychological suffering and unrelieved suffering caused by a serious and incurable medical condition.

The current cost, according to The Guardian, is $3,500, payable to the clinic even if the applicant cancels the request at the last minute.