The right to life is the most fundamental of Human Rights, but when life clashes head-on with a terminal and painful illness, the need to die with dignity and without suffering becomes mandatory. Euthanasia came into effect in Spain on June 25, 2021, and since then, it has allowed more than 1,500 people across the country with terminal illnesses to end their lives without pain, according to data from the Ministry of Health.
In 2023, the Canary Islands was the third community in Spain with the most euthanasia requests registered, 62 in total, of which 25 were carried out.
Not just anyone can access this assisted dying service, as several requirements must be met, including being of legal age and conscious at the time of the request, having Spanish nationality or legal residence in Spain, and fundamentally, suffering from a serious and incurable illness or a serious condition certified by a doctor.
"It's the most positive thing for someone who is having such a bad time"
Juan Luis Navarro's father requested euthanasia in September of this year to be able to die with dignity after suffering a terminal illness that caused him pain and with which his life was slowly fading away. "My father had always told us that before suffering, he would prefer to request euthanasia, he even said it before he was sick," Navarro declares.
"He was very ill and he gathered the whole family at home and told us that he wanted to request euthanasia and what we did was respect his decision," he says. "We put ourselves in his head and we wouldn't want to be as bad as my father was, but I came to terms with his decision to request euthanasia when we saw the doctors enter through the door of my house because we weren't one hundred percent aware," he explains.
"When the doctors came in on the day they were going to give him euthanasia, my father told us before he died: 'They came to put my little wings on', it's a phrase that marked the whole family a lot," he says.
In this case, the deceased was given the green light to his request in just 15 days, also motivated by the severity of his illness. "My father was told by the doctors that even if he didn't receive euthanasia, he could die in approximately two months and we even doubted whether he would make it to the day of administering it," he says.
Juan Luis Navarro had the opportunity, along with his family, to say goodbye to his father in style, even though it may sound strange. "The day before we bought several bottles of rum because he liked it a lot and we had a party with music where my girlfriend also sang," he says.
"We were at home drinking, dancing and enjoying ourselves and, although there were some tears, we tried not to let my father see us but he was super strong in that aspect and we continued until late at night with the party," he says.
The next day, the day on which he was going to be provided with the assisted dying service, his family was with him until his last breath, holding his hand so that he would leave accompanied. "We told him everything we had to tell him, we didn't keep anything and the farewell was very difficult but very beautiful, with a lot of love," he recalls. "My father left very calm and didn't suffer at all, he left in peace, and that's the most positive thing for a person who is having such a bad time," he says.
The importance of healthcare personnel during the process
The process from when euthanasia is requested until it is administered is usually hard, especially for the family because for the patient it is a relief. This is where the support and information provided by healthcare personnel comes into play.
The fact of requesting euthanasia is something that usually impacts families a lot. "They usually accept it because we know that it is a patient who is going to die in the short term and who doesn't want to die badly, but wants to say goodbye with all their wishes and their family, and that they have a pleasant memory of him," says one of the doctors from Molina Orosa.
"We always tell them that even though it is very difficult to say goodbye, it is a very fragile person, and we must respect the wishes of the people and how they want to leave," she declares.
One of the nurses who has carried out one of these assistances together with the doctor has also spoken with La Voz to learn more about what the experience was like, which, in her case, was the first. "When we arrived at the patient's house, his whole family was gathered there and he was still sleeping because the day before he had a party to say goodbye," she says. "When he woke up, all his relatives began to go to the room to say goodbye to him," she continues.
"In the last moments he was surrounded by his whole family and they saw how he left in absolute peace, as if he entered the operating room and fell asleep and after the process they thanked us and were happy," she comments.
The emotional burden is so great in these situations that "it is inevitable to break down with the family, you cry with them but you are left with that gratification for helping," she says.
Bureaucratic process and patient support
From the moment euthanasia is requested until it is administered, the bureaucratic process that it entails is inevitable to guarantee the legality and safety of the procedure. It usually takes approximately a month and a half.
"The first thing that is done when euthanasia is requested is to give the patient a kind of form and initial information about the process and, as a result of this, if the patient is still interested, two subsequent mandatory interviews are carried out in which the doctor who performs the procedure usually goes," explains the doctor.
After this step, the case goes to another doctor who is in charge of evaluating the patient to know their characteristics and verify that the procedure is being carried out correctly. "The case goes to a multidisciplinary evaluation commission, where it is given the green light, or not, to continue, and once they give it to us, in a minimum period of two days we notify the pharmacy to prepare the medication for us," she declares.
A very important point during the entire time that the process lasts is that, at all times, the patient is aware that they can retract if they wish, at any point in the procedure. "It is a process that is usually done in the most respectful way possible," she assures.
"The patient who usually requests the assistance to die generally already has their advance directives and the patient is usually allowed to speak, because they are usually accompanied by patients to the meeting but the family member remains in the background while listening to the questions about whether they have family support or how the family sees that decision," she explains.
Administering the medication
The final step of this process comes with the moment in which the medication is administered, something that can be done in two ways: one is intravenously and the other is with oral medication.
"The first thing that is done is to give the patient a medication to relax them but, despite the fact that they are totally calm and that sometimes even a respiratory arrest occurs before reaching the next medication, we administer a local anesthetic to prevent that, if that were the case, they could not feel it," explains the doctor.
"I always make the simile that there is already enough help to give life without pain like the epidural, but we also have ways to leave without having a bad time because the experiences we have had is that you give peace because just by telling them that they approved the euthanasia request, their gesture changes," she concludes.
