Public health professionals say euthanasia debate is premature

The ongoing debate on Assisted Voluntary Euthanasia (AVE) is “at best premature”, the Malta Association of Public Health Medicine (MAPHM) said on Thursday as it voiced concerns following a review of the government's public consultation document.

In a statement, MAPHM said it fully supported the Medical Association of Malta’s (MAM) position that the current focus should be on strengthening palliative care services.

“MAPHM also believes that, in line with the Medical Association of Malta’s position, the debate on Assisted Voluntary Euthanasia (AVE) is at best premature,” the association said.

It stressed the full implementation of Malta’s Palliative Care Strategy should be a national priority and pursued independently of any discussions around AVE.

“Strengthening palliative care should be a stand-alone and core objective, distinct from such a proposal,” it said.

MAPHM also raised a number of concerns with the content and terminology of the public consultation document, stating the terminology of the document was "incorrect". 

According to the association, what is being proposed more closely resembles physician-assisted suicide, where the final act of administering the lethal substance is carried out by the patient or a proxy.

The association also highlighted a conflict between the proposal and the National Suicide Prevention Strategy (2025–2030), arguing that the introduction of AVE contradicts its principles.

It is concerning and also important to note that this proposal is in direct conflict with the principles outlined in the National Suicide Prevention Strategy, 2025-2030, said the association. 

It also warned that the proposal runs counter to core medical ethics.

The association said there had been a lack of research - both local and international - for proposal, and warned of safeguarding issues such as on vulnerable patients who may feel pressured not to burden their loved ones.

MAPHM strongly objected to a clause in the consultation document that proposed classifying such deaths as “natural” on death certificates, arguing that mortality statistics must reflect the true cause of death.

The association also called for absolute respect for conscientious objection, saying no healthcare professional, or any individual whose work may facilitate the process, should be compelled to participate.

They also urged the government to provide the public with clear and comprehensive information on what assisted dying entails.

The Medical Association of Malta (MAM) said introducing euthanasia legislation was premature, arguing Malta’s palliative care system is inadequate.

It emphasised that end-of-life care must first be significantly improved and warned that legalising euthanasia without proper safeguards poses ethical, medical and social risks.