When 82-year-old Carmen went to a Spanish hospital in 2005 with composite diabetes, hypertension and severe lower gastrointestinal bleeding, Dr Marcos Hourmann says he did his best to save her life.  

“When I first saw her, she asked to die. At that moment I didn’t care about what she said, because even though the situation was complex, terminal maybe, I didn’t respect her will. I worked as a doctor to save her,” he says.  

After medically intervening and later sedating Carmen, who was suffering from advanced cancer of the colon, her condition deteriorated and he realised nothing more could be done medically. 

"The way her daughter felt about her mother at that moment was very important to me... this is the really important instance in the story,” Marcos says. 

After being requested to perform euthanasia by Carmen’s daughter, Marco agreed, despite the fact the act was illegal at the time in Spain. 

“It was my best act as a doctor,” he says, something he still believes to this day. 

In the years that followed, Marcos faced criminal proceedings in Spain and was later struck off from the UK’s General Medical Council (GMC).  

Following a 2016 interview on Spanish TV, he was invited to share his experiences in the form of a play, a production he would later go on to perform the leading role in. 

'I will celebrate my death'

This weekend, starting tonight, the surgeon will be appearing in two performances of I Will Celebrate My Death at Valletta’s Spazju Kreattiv.  

The production tells the story of why he made a choice that would change his life forever and invites the audience to give their verdict on his actions at the end of the performance.  

By inviting the audience to cast their vote, is he somehow seeking redemption? 

“That’s not the point... The message is to write whatever you want, your feelings. I don’t need salvation,” he says.   

Marcos made no attempt to cover up his act to terminate the patient's life. Instead of hiding his actions, he included in his report the fact he administered 60mg of potassium chloride to Carmen.  

But what followed afterward was a “tsunami” in his life. 

While the family did not press charges, the hospital employing him reported his actions, leading to criminal proceedings.  

After having moved to the UK to start a new life in 2006, Marcos was later struck off by the GMC after it emerged he had failed to disclose the case in Spain.  

“I know the rules in England... I know that lying is a very bad thing, and I agree. But I lied, yes, I didn’t say I got a trial, but that was because my career was at risk after what happened in Spain,” he says.  

Does he regret his decision now?

“No, it was the only way I had." 

In 2009, two weeks before his trial in Spain was due to take place, Marcos accepted a guilty plea to escape a 10-year prison sentence. Instead of facing trial for murder, he pleaded guilty to manslaughter and was handed a one-year suspended jail term.   

Marcos has continued to practice medicine since and, in 2021, Spain legalised euthanasia and assisted suicide. 

The play 

Marco admits the theatre production concept did not originate from him. 

Following a TV interview in 2016 as part of a programme about euthanasia, journalists approached Marcos with the proposal of creating a play based on his experiences, a process that would take more than two years. 

After toying with who to cast in the lead role, his colleagues asked him if he would consider taking it on. 

“I said yes, because I’m crazy,” he laughs.  

The play has now been performed over 180 times in Spain. Malta will mark the production’s first performance in English, something that despite its challenges, Marcos felt it important to do. 

“For me, it’s not a job,” he says, adding that for him it is about making people think about the issue. 

What changed in 2005? 

When asked what was different with Carmen than previous patients he had treated in the past, Marcus says his experience with her and her daughter forever changed his mind on euthanasia. 

“As an emergency doctor, the relationship between me and the patients I treat is faster. We find a solution and that's it. We don't have time to feel close to the patient; that's very uncommon. What happened to me was the first time I felt so close with one patient,” he says.  

Did the new experience of connection have emotionally compromised him and affected his judgement?

“Absolutely. Because before I am a doctor, I am Marcos Hourmann... with mistakes and virtues."

Despite his actions that day and since, Marcos does not consider himself an activist for the issue. 

“I am not a euthanasia activist doctor, no. I am an activist for life,” he says.  

Marcos argues that euthanasia should “absolutely” be considered as one of a doctor’s options to treat patients but believes the choice to end one’s own life should never be a snap decision.  

“There should be a lot of tests to determine mental capacity... it’s a long process,” he says. 

Euthanasia in Malta?

In 2021, Labour Party deputy leader Daniel Micallef said his experiences with his late father had confirmed his support for euthanasia, and last year, the PL promised a national discussion on euthanasia as part of its election manifesto. 

“I think it’s a very good thing,” Marcos says when asked his opinion on the pledge.

“It’s open-minded. If you get a law like this, it would make the world a better place.” 

Malta, like Spain, has a strong religious background. Do religious beliefs have a part to play in the debate about euthanasia?

He says he is not religious but insists he respects its importance in society.  

Nonetheless, for Marcos, euthanasia is at its core a humanist issue.  

“Only you can decide how it will end, this is my opinion. It’s a human problem, nothing to do with religion.

“Be free to decide whatever you want... at the end of your life nobody should decide for you."

Asked about the driving force to bring the play to Malta, Spazju Kreattiv’s artistic director Daniel Azzopardi said the organisation has an “integral role in creating an open platform through quality arts events where people can debate topical issues.

“The international premiere of this production at our theatre serves such a purpose and seeks to put the creative sector at the core of social discourse."