The Labour Party has nonchalantly declared that if elected, they will hand over to the people a decision about whether or not the Maltese people want euthanasia to become part of our legal way of doing things. The road to hell is paved with good intentions. This is because intentions alone do not quite cut it in ethical and moral discourse, one must also look at circumstances and the material external object towards which we choose to act.

I am sure that the PL had the good of the economy in mind when they sought to overpopulate the island, as they had the good of the economy in mind when they made the whole island one big construction site, as they did when they gave our hospitals away to Steward, but let me stick to the subject of which I have some expertise, the ethics of medical practice. Unlike Keith Schembri declared unabashedly, most people are interested in doing good and virtue and not only in making money! The practice of virtue it seems, is left to the unprogressive others!

We need euthanasia in this country like we need an epidemic of a serious infectious disease! Doctors and nursing staff already have the means to deal with issues of suffering and dying without letting the patient suffer pain or discomfort and what we really need is proper investment in palliative care, most medicines of which care are not available for public medical use as are not the facilities.

Medical staff already use several ethically accepted methods of cure such as the principle of double effect in the use of sedatives and the avoidance of disproportionate treatment to deal with cases where the patient is irreversibly dying. Patients want to be properly supported and not left alone in their trials not someone to knock them off or help them knock themselves off. Incidentally, euthanasia is not the painless or nonsuffering procedure many people make it out to be, but none live to tell the tale!

I always say, the biggest problem in medicine one can create, is to have doctors have the power to send you to the other side. All medical practice is hitherto built on the Hippocratic principle of beneficence and nonmaleficence, justice and autonomy under the law.

However, if the principles of beneficence (to do good) and nonmaleficence (not to do evil), are turned on their heads and discarded, there will not be a few doctors who will happily comply. The currency of medical practice is often measured in medical resources and hospital beds and not a few doctors will not think twice to dispel patients on their way in order to have better availability of both! The Council of Europe does not condone Euthanasia and neither does the European Court of Human Rights condone a right to die. There is only a fundamental right to live. However, if countries do decide to go down the wrong alley, there is a margin of appreciation which is granted by the Court.

The point is that wherever euthanasia has been allowed on the legal statute books, the authorities have lost control of the situation and the practice goes downhill and gets out of hand in a slippery slope fashion, with many people being dispatched early when they should not be. The cases in hand are too countless to mention. Real investment should be spent on more palliative care, more palliative medicines, more encouragement for private palliative care services, more care for the elderly and sick, more extensive and easily accessible psychiatric services many of the latter not being by any imagination, easily accessible at the moment! The point is not to leave the old, infirm, sick and suffering to face their ordeal alone, but to give them support by all means possible, not offer them a shortcut to death. Death incidentally is irreversible.

The real right is the right to life, and creating a culture of life is what we should be focusing on, not creating a culture of death! This issue of euthanasia is grossly mishandled and miscalculated and unfortunately giving it to the people to handle without the proper knowledge is like asking me to bake a cake. There are too many lattices and inuendoes to be handled with prudence and proper judgement for the untrained mind to come to the proper conclusion. Many people will just sign away their right to life without batting an eyelid. 

This is a fundamental human right issue, and fundamental human rights should not be the subject of legal referendums because they follow from the concept of human dignity, which dignity is absolute. I can say the same thing for the Labour Parties promise to widen prenatal diagnosis for IVF purposes or 'in utero' testing so that any babies to be born not perfect, can be easily summarily dispatched and shredded as they are not fit for a dystopian brave new world. I wonder if they consider Down's syndrome as discardable material as they do not mention which medical and genetic conditions they want to widen the practice of discarding babies to, but just that they want to do it to have more perfect citizens! Forms of euthanasia do not only exist at end-of-life scenarios, they also exist at the beginning of human life and they exist here abundantly too!

As a final thought, I look forward to electoral programs with less of a grim reaper effect and more of a message of hope for those who are alive.

Dr Michael Asciak is a former PN MP