For the Right to Die With Dignity, N.P.A. (DMD)
In different countries of the world there are associations that defend the right to die with dignity, and that in English are known as right-to-die societies. Although the name of many of them involves the idea of “right”, “death” and “dignity”, there is a great variety of names to refer to the idea of having a good end of life, to the possibility of deciding how and when to die, and to have the necessary assistance to die well. Some examples are Friends at the End in the United Kingdom, Final Exit Network and even the Hemlock Society of San Diego that keeps the name of the Hemlock Society, founded in 1980 by Dereck Humphry (a very important activist in favor of the right to decide the end of life). This last organization changed its name in 2003, but it is interesting to note that its original name referred to the method Socrates used to put an end to his life.
Although in 1935 the British Voluntary Euthanasia Society (later named Exit and currently called Dignity in Dying) had already been founded, it was at the end of the 70s and beginning of the 80s that these associations began to appear in different countries of the five continents, and the movement to defend dignity at the end of life began to acquire worldwide strength. It should be noted, not only for Latin America but for the whole world, that the Fundación Pro Derecho a Morir Dignamente (Pro Right to Die with Dignity Foundation of Colombia – DMD Colombia) was one of the pioneer associations, founded even before the aforementioned Hemlock Society.
This movement must be understood as a social expression intending to do something to change the shameful way in which many people died (something that, unfortunately, still happens today). When the sick person was hospitalized to receive the necessary medical care (without the patients or their relatives, or even the health personnel, knowing, in many cases, what that was), he ended up receiving an indiscriminate treatment, something that today is known as “therapeutic cruelty”. This expression encompasses the use of anything medically and technologically available to prolong the life of the patient, but without stopping to determine if it would be a benefit for him, and if it was what he wanted (or would have wanted, in case he could no longer communicate).
The therapeutic cruelty, which is still practiced today, led many people to become interested in being part of a group that guaranteed them that at the end of their lives they would not die in the undesirable conditions in which many saw their parents die; that is, in a way contrary to the values they had always endorsed, such as their freedom and dignity. They saw them trapped and subjected to a technology that could keep functioning the vital organs that were already inoperative. As a matter of fact, all what they did was to prolong his death process. That’s why the first members of some of these associations defended their right to die while they were still alive and not already half dead. For their part, the associations (which continued to grow in number) provided their members with information on the legal decisions that already existed so that they knew which treatments they could refuse as patients, and so they could also prepare their advance directive document so that their wishes directed the decisions concerning their treatments in case they might lose their ability to decide.
Some associations only offered those benefits, but many others defended, as they still do, the right of people to count on the help or the means to end their lives in the best possible conditions, in case they decided the suffering caused by their illness was intolerable and they would rather die. For most associations, advocating this right means promoting legal changes so that euthanasia or medically assisted suicide are allowed in their countries. However, some of them consider very unfair that while legal changes (which are usually very slow) occur, there are people who have to die in conditions of much suffering and unworthiness, which is why they are willing to provide the information so those people put an end to their lives, which in some cases means acting on the verge, not always clear, of legality. What has also happened is that several organizations that originally promoted medically assisted death to be legalized saw that goal met but they didn’t consider their task finished, because they still had obstacles to overcome before they meet their goal, that is, that all people have a better end of life.
At the end of 2015, the association For the Right to Die with Dignity, AC, DMD Mexico, a non-profit association chaired by Amparo Espinosa Rugarcía, sponsored by the Espinosa Rugarcía Foundation (ESRU), and having a board made up of fifteen members, was formalized and made known to the media. This association promotes in our country the right of terminal patients to choose the best end of life, but also advocates the social and legal changes necessary so that Mexicans can legally opt for a dignified death, including that medically assisted death becomes a legal option additional to those that already exist in Mexico, and that basically consist of the right to refuse medical treatments at the end of life, to receive palliative care and to comply with the advance directive document. Those are very important achievements that have not yet materialized in practice as much as they should, because there is a need for more knowledge about them, more clarity in their regulation, and a change in society attitudes so that anyone can speak of death in time and openly when necessary (among family members and with doctors), just to mention some issues.
The activities of DMD Mexico have been mainly aimed at promoting in society the knowledge and debate about death in general and about dignified death in particular, at promoting the use of the advance directive, as well as at advising and clarifying citizens’ doubts related to the legality of actions in medical care and the rights of patients. All this has been done through various activities, including cinema-debates and an important international colloquium held in 2017; also through its website (dmd.org.mx), its presence in the media, as well as the call for essay contests which invite the public to share their end-of-life-related experiences.
A very important DMD Mexico contribution was the 2016 National Survey on Dignified Death, the first carried out in our country to know people’s views about euthanasia and medically assisted suicide, and that generated somewhat surprising data. Thus, to the question of whether a patient who is in the terminal stage of his illness should have the option of deciding to advance his death, almost 70% answered affirmatively; while to the question of whether the laws should be changed to allow the sick people to receive help to end their life if they decided so, a little more than 70% said yes. These data show that, as in many other countries, the majority of the Mexican population wants legal changes to allow medically assisted death and this should be backed by our government. It’s a fact that it will not be easy to get it, because a very careful and widely debated legislation is required to adequately substantiate it, which is why this challenging task should not be postponed further.
Like most associations defending the right to die with dignity, DMD Mexico is a member of the World Federation of Right to Die Societies, whose mission can be summarized in ensuring that all people, regardless of their nationalities, professions, religious beliefs and ethical and political views, can die with dignity, in peace and without suffering. It also seeks that all persons who have full knowledge of the consequences of carrying out their desire to die, taking into account the reasonable interests of others, have access to a peaceful death at the time of their election. Currently, the World Federation brings together 53 associations from five continents, the majority in Euro-pa, eight from Australia, two from Latin America and one from Australia. Since 1976, this federation holds a congress every two years for member organizations to exchange news and points of view and choose the members of the council, in addition to addressing other issues. Like most associations that defend the right to die with dignity, DMD Mexico is part of the World Federation of Right to Die Societies, whose mission can be summarized in ensuring that all people, regardless of their nationalities, professions, religious beliefs and ethical and political views, can die with dignity, in peace and without suffering. It also seeks that all persons having full knowledge of the consequences of carrying out their desire to die, and bearing in mind the reasonable interests of others, have access to a peaceful death at the time of their choice. Currently, the World Federation brings together 53 associations from five continents, mostly from Europe, eight from Australia, two from Latin America and, one Christian from Australia.
Since 1976, this Federation holds a World Congress every two years for member organizations to exchange news and views, and to elect the members of its Council, as well as to address other issues. The next one, to be held in 2020, will be organized by DMD Mexico and will take place in Mexico City. Such an event shall represent a great opportunity for our country to think about dignity at the end of life, to share our experiences, to learn those of other countries, and to give a greater national diffusion to the topic.
As with our very successful 2017 First International Symposium on the Right to a Decent Death organized by DMD Mexico, the date of the next W.F. Congress will coincide with our Day of the Dead celebration. Undoubtedly, this will be a huge attraction for foreign participants, but the Congress, as a whole, will serve to generate in Mexico a greater consciousness about the importance of thinking and talking about death; mostly talking about death itself, first with oneself and then with the other concerned persons being important. Thus, people will be able to choose the best possible end of life they can have.