Exploring medically assisted death in Nigeria: Ethical considerations and possibilities

Death is a topic that is often avoided in conversations among average Nigerians due to its sensitivity, mystery, and gravity. However, the discussion surrounding medically assisted death, also known as euthanasia or physician-assisted suicide, remains a complex and highly debated subject worldwide.

Medically assisted death involves assisting terminally ill individuals suffering unbearably, allowing them to end their lives in a “dignified” manner. This practice, sometimes referred to as mercy killing, is driven by the notion of relieving patients from further suffering. Patients may feel financial and emotional burdens to their families, even when treatment costs are provided or available. It’s important to note that consent from the individual/patient is crucial in assisted suicide, as involuntary euthanasia without permission is considered murder.

While Nigerians strongly desire to improve their healthcare sector, discussions about adopting Western practises often arise. The influence of Westernisation has already led to the adoption of several practises and cultures from other parts of the world. Should voluntary deaths of any kind be considered or overlooked? It’s worth mentioning that voluntary euthanasia is currently legal in several countries, such as Australia, Belgium, Canada, Colombia, Luxembourg, the Netherlands, Spain, Switzerland, and New Zealand. It is also legal in certain U.S. states, including Oregon, Washington, D.C., Hawaii, Washington, Maine, Colorado, New Jersey, California, and Vermont.

Arguably, Nigerian law, cultural norms, and religious beliefs prohibit intentionally taking one’s own life or the lives of others, considering it a grave sin. This includes actively participating in acts that directly cause the death of another person, such as administering lethal medication.

Given Nigeria’s unique cultural, religious, and legal landscape, the question arises: Can medically assisted death ever be a viable option? Are there ethical considerations and possibilities surrounding medically assisted death in Nigeria? The first limitation to consider is the law. What do the existing laws say? Furthermore, moral values, cultural norms, and religious beliefs significantly influence the country and its people. For example, in the southwestern part of Nigeria, there is a Yoruba proverb that states, “iku ya j’ęsin,” which can be interpreted as “death is better than (or preferred to) humiliation.” Contrarily, in the far east, an Igbo saying states, “mkpomkpo ndu kaonwu mma,” which, when interpreted, means “the worst health is better than death.” With such diversity, predicting Nigerians’ stance on the matter is challenging.

There are no specific laws addressing euthanasia or medically assisted death in Nigeria. However, it’s important to note that Nigeria’s legal system combines customary, religious, and statutory regulations. Some existing laws indirectly touch upon aspects related to euthanasia or assisted death, such as laws regarding homicide, suicide, or professional medical ethics.

From a Christian perspective, the Bible does not directly address medically assisted death, as it is a modern ethical dilemma that did not exist during biblical times. Consequently, no specific verse or passage provides a clear and direct answer to this question. Christian denominations and theologians hold various perspectives, with interpretations differing based on principles such as the sanctity of life, compassion, and the role of suffering.

In Islam, views on medically assisted death or euthanasia are generally guided by ethical principles and teachings derived from the Qur’an and the Hadith (the sayings and actions of Prophet Muhammad). Islam strongly emphasizes the sanctity of life, considering it a gift from Allah that should be preserved and protected. Muslims believe that life is a test and that it is not permissible to intentionally take one’s own life or hasten the death of another. Islamic teachings encourage believers to accept and have patience during times of hardship and suffering, including during illness or the end-of-life period. Muslims are taught to trust Allah and believe in His wisdom and divine plan.

To qualify for legal assistance to die in most states or countries, individuals seeking physician-assisted suicide must typically meet specific criteria, including being 18 years of age or older with decision-making capacity, being eligible for publicly funded healthcare services, having a severe and incurable illness or being in an advanced state of irreversible decline in capability, making a voluntary request without external pressure, and giving informed consent after receiving all the necessary information.

The role of a doctor in euthanasia is a complex and ethically debated topic. It’s important to note that the stance on euthanasia varies across different countries and legal jurisdictions, with some permitting it and others clearly stating that the involvement of a neutral doctor should be prohibited. Healthcare professionals may also be unwilling to compromise their professional roles, morals, or religious beliefs based on an individual’s request, particularly in light of the Hippocratic Oath, which discourages engaging in practises that may be harmful or unethical, such as providing lethal medications or participating in euthanasia or assisted suicide.

Arguments supporting euthanasia include dignity, respect for patient autonomy, equal treatment of terminally ill patients on and off life support, compassion, personal liberty, transparency, and the ethics of responsibility, especially when death is imminent. Supporters argue that assisted death can offer a medical option to shorten what the person perceives as an unbearable dying process and can help alleviate the grief and suffering of loved ones.

On the other hand, arguments against euthanasia include concerns about the role of doctors, moral and religious objections, questions about patient mental competence, the slippery slope argument (expanding the practise beyond terminally ill individuals), and the possibility of misdiagnosis or the chance of unexpected recovery. Furthermore, the regulation of euthanasia poses challenges.

Publicised cases have shed light on the topic, such as the televised assisted suicide of Peter Smedley in 2011 and the documentary “The Suicide Tourist” that told the story of Professor Craig Ewert in 2010. These cases demonstrate the global acceptance of the right to life and raise questions about whether Nigeria would be open to such practises.

In 2023, concepts like a DNR (do not resuscitate) medallion will remain foreign to Nigeria’s healthcare system. It is essential to foster open conversations around these topics, considering our ethical, cultural, religious, and legal aspects, in order to shape potential future developments in our country. Encouraging further research and adopting a well-rounded approach to this sensitive issue is crucial.