Parliamentary Assembly

Doc. 8888

7 November 2000

Protection of the human rights and dignity of the terminally ill and the dying

Recommendation 1418 (1999)

Reply from the Committee of Ministers

adopted at the 728^th meeting of the Ministers’ Deputies (30 October 2000)

The Committee of Ministers has carefully considered Parliamentary Assembly Recommendation 1418 (1999) on the protection of the human rights and dignity of the terminally ill and the dying and fully shares the Assembly’s concerns in this respect. The Recommendation raises highly complex problems, which the Committee of Ministers has already considered in various connections, including the 1981 European Health Committee (CDSP) report on care of the dying, the 1988 euthanasia discussions of the Ad Hoc Committee on Bioethics (CAHBI), and the work leading to adoption of the Convention on Human Rights and Biomedicine (the Bioethics Convention).

The Committee of Ministers notes that the Assembly asks it to “encourage the member states to respect and protect the dignity of terminally ill or dying persons in all respects”, particularly stressing, first, access to care, including palliative care; second, the terminally ill or dying person’s right to self-determination; and, third, the prohibition on intentionally taking the life of a terminally ill or dying person.

The Committee of Ministers observes that the CDSP has selected the question of palliative care for a detailed study in 2001. The CDSP intends tackling the question in the wider context of the environment in which palliative care is delivered. The study will look at questions such as over-zealous medical prolongation of life, equal access to health care for old people, professional training in palliative care and reform of medical practice in hospitals and institutions.

As regards terminally ill or dying people’s right to self-determination, the Committee of Ministers draws attention to Article 9 of the Bioethics Convention, which reads: “The previously expressed wishes relating to a medical intervention by a patient who is not, at the time of the intervention, in a state to express his or her wishes shall be taken into account.” It should be pointed out that this wording reflects the maximum convergence of views among states which took part in drawing up the convention as regards reconciling patient self-determination and medical responsibility.

With regard to the absolute prohibition on intentionally taking the life of a terminally ill or dying person, the Committee of Ministers notes that the legal position differs from one member state to another on advance refusal of certain treatments and on euthanasia. Therefore, with a view to obtaining an overview of laws and/or practices of member states with regard to the issues raised by the Recommendation, the Committee of Ministers instructed the Steering Committee on Bioethics (CDBI) to gather relevant information.

Furthermore the Committee of Ministers stresses that protection of the individual’s fundamental rights - including those of the ill or dying - is a matter for the member states, under the supervision, where appropriate, of the European Court of Human Rights. Consequently, the Committee of Ministers has also instructed the Steering Committee for Human Rights (CDDH) to formulate an opinion on Recommendation 1418 (1999).