Ecuador begins the process to legalize euthanasia, drafting rules and requirements

Ecuador’s government has issued the guidelines for the implementation of euthanasia following the Constitutional Court’s (CC) instructions in a ruling granting the request of 42-year-old amyotrophic lateral sclerosis (ALS) patient Paola Roldán who died on March 11. The disease is commonly known as Lou Gehrig’s disease.

Paola Roldán in 2012 before she contracted ALS.

With a 95% disability due to ALS diagnosed three years ago, Roldán could only move the muscles of her face, with no greater mobility in the rest of her body. She had asked for a declaration of unconstitutionality of article 144 of the Organic Integral Penal Code regarding simple homicide, which carries a penalty of between ten and thirteen years in prison. Specifically, she wanted euthanasia recognized as a human right and not be subject to other laws aimed at murder.

The CC Feb. 7 ruling allowed her to have a “dignified” death and gave authorities 60 days to enact the rules under which physicians would apply this ultimate treatment. Henceforth, death resulting from the application of euthanasia will be considered a natural death, the court said.

The CC also gave the Ombudsman’s Office six months to draft a bill regulating euthanasia, while the National Assembly will then have one year to debate and approve it.

The Health Ministry’s 24-article rulebook now lists the requirements for access to euthanasia, which applies only to patients suffering from a serious and incurable disease or an irreversible bodily injury that causes constant suffering and pain. It also describes the possibility of conscientious objections and conflicts of interest.

The patient may also revoke his or her consent to undergo the euthanasia procedure verbally at any time prior to the beginning of the procedure itself. The life-ending drugs must guarantee that the procedure is short and simple, with a lethal dose based on current international protocols, the document also states.

Ecuador thus joined neighboring Colombia as the only countries in the region to recognize euthanasia as a viable option for terminally ill people. In January 2022, Víctor Escobar and Martha Sepúlveda became the first two people to be euthanized under Colombian euthanasia rules.

The 51-year-old Sepúlveda also suffered from ALS. She had been scheduled to die on Oct. 10 the previous year but the procedure was suspended at the last minute when the Scientific Committee for the Right to Die with Dignity determined that “the termination criterion as had been considered in the first committee was not met” although she had repeatedly expressed her desire as her health deteriorated and her quality of life worsened.

The objections were overcome as she was allowed to end her life.

Escobar suffered from obstructive pulmonary disease and hypertension. He needed oxygen to breathe and had undergone spinal surgery three times after a car accident. He had also had several cerebrovascular episodes in addition to mobility problems.

Euthanasia had been legal in Colombia since 1997. However, it was not before 2015 that the Constitutional Court expanded the list of cases in which it could be requested for non-terminally ill people who nevertheless went through “intense physical or mental suffering from bodily injury or serious and incurable disease.”

Euthanasia is also legal in Belgium, Canada, Spain, Luxembourg, New Zealand, and the Netherlands. Four other countries in the region have legislation on dignified death, which differs from euthanasia in that the patient does not die but instead has the right to refuse life-extending treatments: Argentina, Brazil, Uruguay, and some states from Mexico.