Estonian Council of Churches: End-of-life declarations must not legalize euthanasia

TALLINN - The Estonian Council of Churches emphasizes that the process of developing declarations on end-of life-medical care must not open hidden pathways to legalizing euthanasia.

Having reviewed the document of legislative intent, the council highlights the importance of raising awareness and developing palliative care options. 

“We see this as a humane approach to life and care, providing an alternative to possible attempts to legalize euthanasia, which we strongly oppose," the Council of Churches said.

The council stresses the need to ensure that the legal and practical solutions associated with the end-of-life declaration do not covertly enable the legalization of euthanasia.

The council believes it is essential first to define what is meant by "end-of-life."

"This would provide a clearer understanding for both the patient and the advising doctor of what is being discussed when making the declaration. Currently, the term 'end-of-life' can be used in various contexts," they stated.

The Council of Churches interprets end-of-life as a situation where the patient is inevitably dying and has only a few days or weeks to live from a medical perspective.

"The term 'end-of-life' should not automatically apply to individuals with incurable cancer, degenerative diseases, persistent vegetative states, comas, or dementia. Being in a medically severe condition does not necessarily mean one is at the end of life. To determine that a patient is truly at the end of life, there must be clear and demonstrable deterioration in vital functions, with no possibility of recovery, leading to death within a short time," they assert.

The council is concerned about the inclusion of the condition "I am unconscious or unable to express my will for other reasons" in the declaration.

"Marking this option could make medical assistance impossible in situations where health improvement through medical aid is expected, such as in cases of suicide attempts, overdose, or unexpected, non-self-inflicted unconsciousness. This is not acceptable under medical principles and ethics," they stated.

Regarding the quality of life and refusal of treatment, the council believes that for patients who are truly at the end of life, the usefulness of any treatment should be medically evaluated to avoid both disproportionate medical intervention and euthanasia.

Additionally, the council stresses the importance of giving patients the opportunity to consult with a mental health specialist and, if desired, their spiritual advisor or chaplain before formalizing an end-of-life declaration.