Non-profit organisation DignitySA has filed a landmark lawsuit in the Pretoria High Court, seeking to decriminalise assisting terminally ill people in dying. This step is a crucial event in the broader debate around medically assisted dying. It also signifies a breakthrough in the ongoing national discussion about end-of-life treatment and patient autonomy.
According to the organisation, existing bans are unconstitutional. DignitySA claims that they conflict with the South African Constitution, which guarantees the rights to human dignity and to the bodily integrity of the person. Beyond declaring the bans unconstitutional, they demand that the legislature pass a new law to regulate the issue. The legislature must enact this law within two years of the ruling.
The Constitutional Argument for Medically Assisted Dying
Willem Landman, the founder and chairperson of DignitySA, states that current legislation infringes on patients' rights. He claims that it robs the individual of their right to pass away with dignity. Existing legislation classifies providing help to people in the terminal stage as murder. Furthermore, the law bans health professionals from offering any form of assistance.
The lawsuit concentrates on the following parts of the Constitution:
- Article 10 – the right to human dignity;
- Article 11 – the right to life; and
- Article 12 – the right to bodily and psychological integrity.
According to Landman, the ban imposes unnecessary torture on patients. He cites 11 examples of unbearable suffering to support his application. As one of the most notable cases, he mentioned the recent death of MP Mario Oriani-Ambrosini. The MP committed suicide following the diagnosis of terminal illness.
Overcoming Regulatory Barriers to Medically Assisted Dying
Another important aspect of the case is the Health Professions Council of SA (HPCSA). Current regulations classify assisted dying as unethical and categorise it as professional misconduct. DignitySA has been advocating for changes for 15 years. They want to legalise both self-assisted and assisted forms of ending life.
This case is a follow-up to the 2015 request by advocate Robert Stransham-Ford. Although he won the first ruling, the Supreme Court of Appeal (SCA) overturned the order. The SCA's judgment was based solely on procedural grounds. It provided no clarification concerning the legality of the practice.
Addressing Concerns About Inequality and Vulnerability
The current ban produces "an arbitrary effect" on people. While wealthy patients can travel to countries like Switzerland or the Netherlands to seek assisted dying, those without the means must face an agonising death. Additionally, some patients cannot act independently, which puts their relatives at risk of facing murder charges.
To address concerns that the law might force euthanasia on marginalised communities, Landman cited data from countries that permit the practice. He noted that access thresholds remain constant and found no evidence that anyone is exploiting vulnerable populations.
The Minister of Health and HPCSA have become respondents in this case. The healthcare industry is awaiting a decision that may radically transform the ethics of medical professionals in the region.
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