As chairman of Parliament’s Family Affairs Committee, Godfrey Farrugia is leading the discussion on some very sensitive topics, such as euthanasia and the morning-after pill – even though he does not agree with either, as he tells Kurt Sansone.
You chair Parliament’s Family Affairs Committee that heard Joe Magro, a man suffering from ALS, make his case for euthanasia to be legalised. What are your thoughts on the subject?
I am a doctor and I have experienced this situation many times during my career. I have lived through the difficult moments of many patients of all ages. I have also experienced the pain relatives go through. It is a very complex issue with legal, social and ethical implications. Apart from the individual’s right there are also the rights of his relatives and the community at large that have to be evaluated. The patient’s right to die imposes an obligation on the doctor to become an executor. Apart from opening avenues for abuse, the doctor’s right not to be part of this has to be recognised. As a doctor I have always been a life saver.
You have someone asking you to allow him to die in dignity because he does not want to end up totally dependent on others – a life he describes as lacking dignity. How difficult a choice is this for a doctor like you?
I have seen patients who have asked to be discharged from hospital to go and die at home because they felt the end was near. I have known patients who even prepared for their own funeral mass. I believe that if a patient’s quality of life is not good enough to allow him to live in dignity than society has much more to do to ensure he gets all the support necessary. I know people in vulnerable situations who feel at ease because of the love shown them by their relatives. Life is as beautiful as you make it and society must offer these people all the support they deserve.
Despite all the support society can offer, it will not change the fact that someone like Mr Magro could end up totally paralysed. He simply does not want to live a life in total paralysis, which makes him dependent on others for everything. He wants the choice to end his life in dignity.
The choice to end his life is not only his own. Apart from making sure the individual has the mental capacity to make such a decision, we have to understand whether the person’s life is worthless and helpless. These are important factors when dealing with terminally ill patients. In Joe’s case, he suffers from a disease for which we know the prognosis [a neurodegenerative disease that progressively robs the individual of his ability to move his muscles], but the progression is not the same for every patient. We need to adopt caution.
There could be an instance when the patient in a total state of paralysis changes his mind on a decision he would have taken earlier in life to undergo euthanasia. If he cannot communicate the new decision, we could be going against his will by going ahead with euthanasia. I totally disagree with a situation where relatives decide on behalf of the patient.
You are positing an extreme case where the individual will not be able to communicate in any way. But in Mr Magro’s case there are methods by which a patient in total paralysis could communicate his wish to die. Such a person, today, has no right to choose death.
Yes, but life should be safeguarded.
At all costs?
As a doctor, I am 100 per cent against euthanasia. As a politician, I am ready to listen
Yes, I personally believe that I should do my best.
Even if the quality of that life does not afford the individual dignity?
Society has a duty to ensure the individual’s dignity is preserved by improving his quality of life. There would be something missing in society if at the moment when we are most vulnerable, quality of life cannot be assured. This is how I view it as a doctor and I do not think I am the only medical professional to see it this way.
There are instances when doctors decide to stop treatment because it becomes evident there is no hope for improvement. But euthanasia is something different and has so far only been introduced in some American states and a handful of European countries. In the UK a proposal to introduce euthanasia was blocked last year. Euthanasia also carries a high risk of abuse and is not an easy subject to legislate on.
A patient has a right to refuse treatment. Hospitals ask patients to fill in a consent form when they undergo surgery. And yet, despite this emphasis on the patient’s right to make choices about his care, we are denying him the ultimate choice to die in dignity.
When we speak of end-of-life decisions, the right to life is supreme. There are man-made laws, linked to culture and trends but there are also the universal laws dictated by fundamental human rights. The fundamental human rights are supreme to man-made laws. When we speak of the right to life – above politics and above religion – I believe the individual must not be his own executor.
Are you against euthanasia?
As a doctor, I am 100 per cent against euthanasia. As a politician, I am ready to listen.
Despite your views on euthanasia, you have promised the debate in Parliament will not stop with this one hearing where Mr Magro made his case. Why?
What I believe as a doctor is one thing, but as a politician I have a duty to listen, understand, analyse and reach a conclusion. I heard Joe Magro and in October I will call a joint meeting of the health, family and social affairs committees to listen the views of other people from different professions on euthanasia.
You also intend to discuss the morning-after pill. On Facebook you said “let us call a spade a spade: this pill may be abortive”. Why did you say this?
The progesterone tablet, containing levonorgestrel, is recommended to be taken in the first 72 hours after the woman had unprotected sex. If ovulation would have already happened than it is possible for fertilisation to have occurred. If ovulation would not have happened, the sperm has nothing to fertilise. If a doctor wants to prescribe the morning after pill in an intelligent way, he can use the fertility test to determine whether the luteinising hormone has surged, which would indicate ovulation is about to happen. This test is more than 99 per cent accurate.
The morning-after pill – which induces an earlier period – would definitely not be abortive if the test shows ovulation has not happened yet. But if ovulation has happened, the dilemma crops up as to whether fertilisation has occurred. In this instance emergency contraception may be abortive because the zygote will be washed away with the uterus lining. I believe human life starts at conception, with fertilisation.
Not even with implantation.
No, that has nothing to do with it.
Fr Peter Serracino Inglott once questioned whether we can speak of the existence of a person for up to 14 days after conception, since it is still possible for the zygote to split and form identical twins. He argued that human life had started but questioned whether that equated to the existence of a person, at least until after the 14 days are up.
But human life would have begun before that period. Siamese twins are the exception to the rule. The American gynaecological association has defined pregnancy, very conveniently, as starting from the fifth day onwards when implantation has occurred. But conception happens in the fallopian tube, the fertilised egg then travels down to the uterus and implants itself in the uterine wall. I personally believe that when the genetic material of the sperm and the ovum fuse, a new person has been formed and that is before implantation happens.
Do you oppose the morning-after pill being available in pharmacies?
If a woman comes to me asking for the morning after pill I would first insist on the ovulation test.
You are aware that some doctors have prescribed overdoses of the ordinary contraceptive pill to women in need of emergency contraception.
I am aware and I have always resisted this. It is important that we take a holistic view of health. If MAP is to be available on the market it should be sold on prescription and not be available over the counter. Buying MAP over the counter does not afford the level of patient confidentiality necessary if the individual would want to ask the pharmacist some questions.
A doctor will be able to provide advice, not only on emergency contraception but also ordinary contraceptive methods and sexually transmitted diseases. Strengthening the patient-doctor relationship is important and I believe it is also about time to make it possible for doctors to be able to treat people between 16 and 18 without the parents’ consent. These youngsters should have the right to go to a doctor.
You have reservations on emergency contraception, yet you pledged to discuss the issue in a joint parliamentary committee over the summer.
Yes, that is how it should be. The debate will start on Wednesday.
Where do you intend to take this discussion, because as things stand it is just an administrative decision by the Medicines Authority that will determine whether the morning after pill is authorised for sale?
I believe the people should be educated and informed about the subject. I would like to have access to scientific research on both sides of the debate. But we also have to explore the legality of the situation, since I have heard people saying MAP is illegal under current legislation. An in-depth study of this sort is important for everyone. Parliament should drive the agenda.
You would like to see a debate on forced and early marriages. Is there a pressing need to put this issue on the agenda?
We have incongruence in the law between the age at which marriage is allowed – 16 – and the criminal code, which makes it illegal to have sex with someone aged under 18. This is being dealt with in the debate on lowering the age of sexual consent…
Society has a duty to ensure the individual’s dignity is preserved by improving his quality of life
But in reality, how many 16- and 17-year-olds do we have getting married? The NSO statistics for 2014 showed the youngest person to marry was 19 years old.
Don’t forget we are living in a multicultural society. It is not just a question of Maltese marrying Maltese. Just like we made it illegal to have female genital mutilation, a cultural practice in some African communities, we have to look at the issues from a wider perspective.
What are you suggesting?
We have to consult the public, see what the experts have to say, and if necessary change the law to increase the marriage age.
The proposal is to have the age of sexual consent drop to 16 because of psychosocial parameters, but this does not need to apply to marriage. At 16 a person can work and vote in local elections but it is illegal to sell alcohol to those below 17. A car licence can be obtained at 18, not younger.
Should we increase the age of marriage to reflect the importance of the commitment the individuals involved are making? This would also prevent forced marriage at a young age.
You refer to Malta as a multicultural society. There are some who are scared of this concept.
Those who are scared of multiculturalism do not realise we already live in such a society. I believe in inclusion.
The problems that we witness in other countries are many times the result of a lack of inclusion [of foreigners].
But how comfortable are politicians in speaking of inclusion when many of their constituents are not too keen on it?
I am comfortable.
We are not realising that inclusion does not imply only irregular migrants.
There are 80 nationalities living in Qawra. We are already multicultural. Inclusion is something I believe in.
Two minds, one purpose
Godfrey Farrugia sits down at the table in his parliamentary office and immediately shoots out: “Ask me about Marlene Farrugia.”
He has anticipated the questions which I had intended to ask at the end of the interview.
“You are obviously going to ask me about her, so let’s get this part out of the way,” he says with a smile.
His pre-emptive move is indicative of the sensitivity of the subject. Marlene Farrugia resigned from the Labour Party last year, retained her parliamentary seat and went on to form a new political party, all while her partner Godfrey serves as the Labour government Whip.
He makes it clear he has nothing to do with the new party and professes his “firm loyalty” to the Labour manifesto.
However, he admits living a continuous struggle within the party ranks to keep the democratically elected Labour government “on the right track”. “It is a track constructed out of a steely resolve to swerve in the direction of transparent, good governance and a dignified life for all our citizens and residents from conception till death,” he says.
It is because of this “burning resolve”, as he describes it, and which dragged him into politics, that he cannot register any conflict with Marlene on political views and principles.
“Marlene and I are saying the same thing, have the same objective, but pick different routes to reach those objectives… as for the Orange Democratic Party, it has my respect, of course, but I am firmly dedicated to my duties in the Labour Party.”
But he surely must have an awkward situation at home, discussing politics with his partner, I surmise.
“We are two minds with one purpose,” he tells me. “Our purpose is good governance, a just society that prides itself in civic sense and environmental sustainability.”
He rationalises the domestic situation into neat boxes, but I suggest there must be awkwardness when Marlene rises in Parliament to hit out at ‘his’ side.
“I feel that criticism, but it so happens that I am one of those who believe in good governance,” he says.
Some of Marlene’s harshest criticism yet came during the debate on a motion of no-confidence in Konrad Mizzi that she put forward. Hers was an impassioned plea for government MPs to stand up and be counted.
“You know how I spoke in that situation,” he says, justifying his eventual vote against the motion of no confidence.
“After all I am the government Whip, but if you analyse my speech on the motion of no-confidence in Konrad Mizzi, I ended it with a forward-looking statement, calling on all politicians to make a new pact with ourselves,” he says.
Godfrey Farrugia had been among other Labour MPs who voiced deep concern about Dr Mizzi’s involvement in the Panama Papers scandal, insisting prior to the vote that if it were up to him, he would have resigned.
And yet, like all other government MPs, he voted against censuring Dr Mizzi’s behaviour despite the unease the situation created.
“It was the Prime Minister’s prerogative to decide how to discipline a minister and we accepted the decision he took,” he says.
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