In some good news, the European Court of Human Rights (ECHR) has recently ruled [1] that there is no right to assisted suicide under the European Convention on Human Rights, allowing individual signatory States such as Ireland to continue banning euthanasia and similar practices.
Last month, the ECHR ruled on the case of Dániel Karsai, a Hungarian lawyer suffering from amyotrophic lateral sclerosis (ALS). Mr Karsai argued that Hungary’s ban on euthanasia and assisted suicide violated his human rights under Articles 8 (respect for private and family life) and 14 (prohibition of discrimination) of the European Convention on Human Rights.
Mr. Karsai maintained that he was being discriminated against because terminally ill patients in Hungary are allowed to withdraw from life-sustaining treatments, but he had no option to hasten his death. Hungarian law criminalises facilitating suicide, even if it occurs abroad. Given his condition, Mr. Karsai claimed he could not end his life without assistance, which he argued was discriminatory.
The Court, which has jurisdiction over 46 member States of the Council of Europe, affirmed that there is no right to assisted suicide in the European Convention on Human Rights. In a 6-1 majority decision, the ECHR rejected Mr. Karsai’s arguments, recognising the distinction between the right to refuse or withdraw from medical treatment, which is common among the members of the Council of Europe, and the request to be actively killed or helped with suicide.
The Court acknowledged that while what they call “physician assisted dying” (PAD) has been introduced in some countries, “the majority of member States continue to prohibit and prosecute assistance in suicide, including PAD. Moreover, the Court notes that the relevant international instruments and reports, including the Council of Europe’s Oviedo Convention, provide no basis for concluding that the member States are thereby advised, let alone required, to provide access to PAD”.
The judges observed that opinions on this topic differ profoundly in democratic countries, granting member states a considerable margin of appreciation (that is, freedom to decide their own laws). This means States are free to legislate on the matter of euthanasia and assisted suicide according to their societal values.
The judges observe that “the wider social implications and the risks of abuse and error entailed in the provision of PAD weigh heavily in the balance when assessing if and how to accommodate the interests of those who wish to be assisted in dying.” The member States enjoy considerable freedom in deciding how that balance should be struck.
The ECHR noted that the available options in palliative care, including the use of palliative sedation, are generally able to provide relief to patients in Mr Karsai’s situation and allow them to die peacefully.
Mr Karsai complained that Hungary’s law considers as a criminal offence the facilitation of suicide even when it happens abroad. The Court replied that this is nothing unusual or excessive. “The criminal prohibition on assisted suicide is intended to deter life‑endangering acts and to protect interests arising from considerations of a moral and ethical nature”, they said, and the State is entitled to extend this protection of its citizens even outside its borders.
This is an important ruling that reaffirms that, even as euthanasia and assisted suicide are gaining wider acceptance, they are not human rights under the Convention and States have no obligation to permit these practices.