The recent government paper on assisted euthanasia outlined proposals for a national discussion, as pledged in their last electoral manifesto. Several key points emerged during public consultations.

Firstly, the paper begins with a textbook definition of euthanasia, tracing its Greek etymology: "a good death". While I'm not a historian, the Greek roots of the term draw heavily from the culture and mythology of that era and do not necessarily align with our current context. Let us agree on one thing - there is no such thing as a "good" death. Death, especially one that is planned, cannot be good. The best we can hope for is an acceptable death.

The paper outlines a number of proposed safeguards. In brief, the request must be made freely and expressly by the patient, following a full explanation of the available palliative care and support options. A team of three professionals, including a psychiatrist, would need to assess the case. Family members would not be allowed to decide on behalf of the patient. These sound like robust safeguards - at first glance. But the devil is in the details, as public discussions have revealed.

Palliative care in Malta is still lacking, and significant improvements are needed to increase the availability of treatments aimed at relieving pain and suffering. Simply informing a patient about what is available is not enough. They should also be informed of what is not available here, but might be elsewhere. Before we even begin to discuss euthanasia, we must first invest in and expand our palliative care system, armed with the best pharmaceutical tools and proper safeguards to prevent abuse. This was one of the most evident takeaways from the consultations. This point was eloquently made by the Archbishop in his pastoral letter:

"It is appropriate to use medicine to ease the suffering of those in critical condition, and to administer this not with the intention of causing death, but to relieve pain - even if, as a consequence, life may be shortened."

Then there's the matter of prognostic decisions. These are not exact science - they rely on statistics and professional experience, and are therefore inherently subjective. Even the wording of the proposed safeguard reflects this: "reasonably expected." Many participants shared personal stories of loved ones who were given short prognoses but lived on for years. So how much of a "safeguard" is this really? It feels more like a necessary checkbox than a truly protective measure.

Regarding the exclusion of family members from the decision-making process, the pastoral letter offers a sobering reminder: "A right to die can become a duty to die." In our society, where family ties and relations are central to the day-to-day realities of life, decisions such as this are rarely made in isolation. Family influence is a reality, and virtually impossible to eliminate or regulate. The effectiveness of this safeguard is, therefore, highly questionable.

We also need to consider who is making the proposal. This is a government with a poor track record in healthcare - failing to upgrade mental health facilities or scale the national health system to meet the needs of a growing population. And all this besides the Vitals/ Steward scandal. Given this context, I suggest that the government temper its ambitions in pursuing a liberal agenda and instead focus on practical, tangible goals: improving general healthcare services, mental health care, and suicide prevention efforts.

Other proposals in the paper have received less attention but are significant nonetheless. Chief among them is legislation for medical wills, which I strongly support and believe should be implemented promptly. The rest of the document, however, appears to be laying the groundwork for assisted suicide, cloaked in more neutral or ambiguous terminology.

As a professional who deals with euthanasia oftentimes on a weekly basis - albeit with animals - I can understand some of the emotional weight it carries, the heartache it leaves behind, and the complexity of the decision-making process. Issuing accurate prognoses is difficult. Often, they serve more to ease the patient's fear of the unknown than to offer certainty. Healthcare professionals are often unprepared to deal with the emotional burden. Bedside manner in such cases is especially delicate. Your connection with the patient, your own confidence, your commitment to your work - all are put to the test. These decisions follow you home. They weigh on the conscience and can have lasting effects on one's ability to perform their job long-term.

Let us, then, focus on what truly matters: care for the patient. Let us improve our healthcare systems and ensure that palliative care offers the best, most compassionate support possible for those facing terminal illness. In doing so, we can achieve the same end - a dignified, pain-free death - without the ethical and emotional complications that come with assisted suicide.

Dr Andrew Agius is a veterinary surgeon and new candidate for the Partit Nazzjonalista on the third district.