The decision of terminally ill patients to end their life must be respected, and those who are healthy are in no position to judge the ethical issue of euthanasia, the president of the Malta Union of Midwives and Nurses (MUMN) said on Monday. 

Paul Pace was speaking to Times of Malta following the government’s announcement last week of a national discussion on assisted voluntary euthanasia.  

“The decision by a patient suffering from continuous, unbearable pain and facing a terminal illness deserves respect,” Pace said.

“No individual has the right to pass judgment on a dying patient enduring such pain. To do so is not only unethical but also inappropriate and unnecessary.”

Pace argued that euthanasia should not be treated merely as a matter of personal opinion or preference but as a deeply ethical issue. Nurses, he said, often have a different perspective on this sensitive topic because of their daily experiences with patients in severe pain.

“Nurses witness first hand the agony these patients endure,” he said. Drawing on his decades of experience, he explained that there were cases where pain persisted in spite of the strongest medication.

“Not being able to help isn’t easy because as nurses we also carry that pain. It is very upsetting sometimes… very.” he said. 

Euthanasia 'should not take place in public hospitals'

He said that, while he supported the government’s decision to launch a national debate, he did not agree with every proposal put forward. Specifically, he opposed allowing assisted euthanasia in public hospitals.

“Euthanasia is not appropriate within a hospital setting. A designated place should be established for that purpose,” he said.

Still, Pace was firm that euthanasia should never replace or undermine palliative care. He said the MUMN was working with the Health Ministry to develop more accessible community-based palliative care services.

He emphasised the importance of supporting families who wish to care for terminally ill relatives at home. With the provision of a 24-hour carer, a special bed, and all necessary medications without bureaucratic hurdles, families could provide dignified end-of-life care, he argued. 

Under the government’s proposals, only patients who are terminally ill with less than six months to live, and who are mentally capable of making the decision, would be eligible to request euthanasia. The choice must be entirely voluntary and made by the patient alone.

No third party would be authorised to make the decision on the patient’s behalf, and no one may be coerced or encouraged into it. Patients must be over 18 and must have exhausted all available treatments.

Euthanasia will not be available to people with disabilities, mental health conditions, or illnesses linked to old age.