Legalización de muerte médicamente asistida: discusión sobre el potencial impacto en el desarrollo de cuidados paliativos / Legalization of medically assisted death: its potential impact on the development of palliative care

ABSTRACT

In Chile, there are four bills to legalize euthanasia, an act which public surveys report as supported by most of the population. At the legislative, healthcare and social level, there is an active debate about euthanasia, the rights of terminally ill patients and the context of Palliative Care (PC) in the country. Chilean literature on euthanasia focuses mainly on the ethical analysis of the act itself but does not address the moral legitimacy of the legalization of this practice. This distinction is relevant since the probity of a particular action does not determine the moral legitimacy of its implementation at a public policy level. One aspect of this dimension is the potential negative impact of the legalization of physician-assisted death (PAD) on the development of PC services. This issue is particularly relevant in Chile, where PC provision is currently suboptimal and mostly restricted to cancer patients. This paper analyses available evidence on the potential impairment of PC development after PAD legalization. Although the analysis of evidence has some limitations, this concern is not supported by the available evidence. However, any project about PAD legalization must contemplate a factual commitment with the development of minimum PC provision, according to international recommendations.