‘We’ve won the battle but not the war’: Spain’s euthanasia campaigners on new law

In 1998 Ramona Maneiro helped her friend Ramon Sampedro, paralysed from the neck down following an accident, to die, a tale told in the Oscar-winning Spanish film "The Sea Inside".

'We've won the battle but not the war': Spain's euthanasia campaigners on new law
Spanish Ramona Maneiro, gives a press conference in Boiro, northwestern Spain, 17 January 2005. Maneiro has admitted assisting the suicide of Ramon Sampedro, a tetraplegic writer whose 30-year battle for a dignified death was immortalized by film director Alejandro Amenabar in his recent blockbuster "Mar adentro" (The Sea inside) . AFP PHOTO/ STR (Photo by STR / AFP

Now over two decades later she will celebrate the expected passage on Thursday of a bill allowing euthanasia in Spain under strict conditions.

Maneiro, 60, recalled how she put a glass of water mixed with a bit of cyanide with a straw in front of Sampedro, so he could sip it while a video camera recorded his final moments and his explanation for wanting to die.”He had decided to go,” she told AFP near the port of Vigo in the northwestern region of Galicia, her salt and pepper hair gently swaying in the marine breeze.

“After, I put myself behind the camera, against the wall almost… until the end,” she added.

READ ALSO: What you need to know about Spain’s proposed euthansia laws

A national debate

Sampedro’s death at age 55 stirred a national debate over assisted suicide and fuelled calls for it to be legalised.

He was a 25-year-old merchant marine when in 1968 he dived into a shallow creek near his home in a village near Vigo and broke his neck, leaving him a bedridden tetraplegic.

Frustrated at the thought of being dependent on his family for the rest of his life, he fought an unsuccessful 30-year court battle to be allowed to end his life with dignity.

His case gained international attention thanks to the success of “The Sea Inside” which won the best foreign language film at the 2005 Academy Awards. In it Sampedro is played by one of Spain’s leading actors, Javier Bardem.

If euthanasia had been allowed at the time, Maneiro wouldn’t have risked prison to help her friend.

She was arrested but released due to lack of evidence. Seven years later, after the statute of limitations had expired, she admitted her role in Sampedro’s death in a TV interview.

While Sampedro’s family blamed her for his death, the former fish cannery worker said she did not feel “guilty of anything”.

The legalisation of euthanasia was coming late, but it was a “victory” for those who “could benefit from it” as well as “for Ramon”, she added.

‘Like a vegetable’

The bill, set to get final approval in parliament on Thursday, will allow someone suffering from a “serious or incurable disease” to receive medical assistance to die.

Sofia Malagon, who was diagnosed with Parkinson’s disease in 2014, said the law gives her “peace” in case she “needs it one day”.

The progressive disease, which produces tremors and stiffness as well as problems walking, has already forced the 60-year-old Colombian who lives in Barcelona to give up her job as a nurse.

“Dying or living badly worries me… if I get dementia I won’t be Sofia anymore,” said Malagon, who has a masters in bioethics and has been active in the fight to legalise euthanasia.

“I don’t want to be left there like a vegetable,” she added in front of her huge library at her flat near Barcelona’s iconic Sagrada Familia basilica.

“Medicine should not only cure, it should also avoid suffering.”

While she welcomed the new law, she is not pleased that it gives doctors from the national health service the right to object on grounds of personal conscious.

“We won the battle but now the war,” said Malagon.

‘Suffering and pain’

Jesus Blasco, a cheerful 88-year-old, said he wanted to die after he underwent throat cancer surgery.

After spending five months in hospital where he was fed through a tube, doctors predicted a life without being able to eat or drink again.

He ignored their advice and began to eat again, but said he would consider euthanasia again if his health worsened.

“If continuing to live must be done at the cost of suffering and pain, I will give up,” the right-to-die activist said, speaking from his Barcelona home.

Like Malagon, he is worried that the new law is “decaffeinated” — that it applies to a narrow range of cases.

He is especially concerned that euthanasia will only be allowed “when the pain is unbearable”.

“Who will determine whether my pain is unbearable of not? A priest, the pope, politicians? It’s up to me.”

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Switzerland: What is the difference between assisted suicide and euthanasia?

While the terms often are used interchangeably, assisted suicide and euthanasia - and the laws that govern them - are quite different. Here’s what you need to know.

A person in a medical coat holds hands with another
Euthanasia and assisted suicide might be spoken of in the same breath, but they are quite different. Here's what you need to know. Photo by Matheus Ferrero on Unsplash

The terms assisted suicide, assisted dying and euthanasia are often used interchangeably – even by media and politicians covering the matter. 

There are however some key differences, both in terms of the legal situation and the practice itself. 

Assisted suicide is where a medical professional, usually a doctor but sometimes a pharmacist or other specialist, provides some form of medication to assist a patient as they commit suicide. 

EXPLAINED: How foreigners can access assisted suicide in Switzerland

Crucially, it is the patient who takes the final step, i.e. by taking a medication or by pressing a switch through which the medication is administered. 

Euthanasia on the other hand is where the medication which ends someone’s life is administered by a doctor or medical professional. 

Euthanasia is sometimes known as voluntary euthanasia, which references the fact that the patient volunteers for the process by providing consent. 

Other forms of medical intervention which lead to death – for instance turning off life support for someone who has been in a long-term coma – do not fit within the definition of voluntary euthanasia. 

The term ‘assisted dying’ is used as a grouping term to refer to both assisted suicide and euthanasia, although media sources – particularly in the United Kingdom – often use assisted dying when referring primarily to assisted suicide. 

What are the rules for assisted suicide and euthanasia in Switzerland? 

The law in Switzerland recognises the distinction between assisted suicide and euthanasia. 

Euthanasia is not permitted under law in Switzerland, while assisted suicide is allowed for both locals and foreigners. 

While article 115 of the Swiss penal code prohibits assisted suicide for “self-serving reasons” and article 114 prohibits “causing the death” of a person for “commendable motives, and in particular out of compassion for the victim”, assisted suicide for non-selfish reasons is not specifically prohibited as long as certain conditions are met. 

The Swiss supreme court has ruled the following: people must commit suicide by their own hand, for example, by taking medication themselves. A doctor cannot administer a lethal injection without being liable for criminal prosecution.

People must also be aware of actions they are undertaking and have given due consideration to their situation. In addition, they be consistently sure they wish to die, and, of course, not be under the influence of another person, or group of persons.

READ MORE: What you need to know about assisted suicide in Switzerland

Several other jurisdictions across Europe and the globe also make a legal distinction between the two, although euthanasia is legal in some countries including the Netherlands, Belgium, Luxembourg and Columbia. 

What is the medical procedure involved?

Most Swiss associations request that patients drink sodium pentobarbital, a sedative that in strong enough doses causes the heart muscle to stop beating.

Since the substance is alkaline, it burns a bit when swallowed.

A professional prepares the needle, but it is up to the patient to open the valve that allows the short-acting barbiturate to mix with a saline solution and begin flowing into their vein.

A video is shot of the patient stating their name, date of birth and that they understand what they are about to do. The camera keeps rolling as they open the valve and the footage is used as evidence that they willingly took their own life.

It usually takes about 20 to 30 seconds for the patient to fall asleep.