Finally, the proposal proposed by the Podemos group for an organic law, the examination of which was rejected by the Chamber of Deputies at the end of March – 86 deputies in favour, 132 against and 122 abstentions – is the only one that directly concerns euthanasia and provides for a modification of the wording of the Penal Code. Article 143.4: “The conduct of a person who cooperates in necessary and direct acts on another person or causes his death, if he has expressly, unequivocally and repeatedly requested it in accordance with the provisions of the specific legislation, is not punishable. The applicant must suffer from a serious illness that necessarily results in his death or that suffers from physical or mental suffering that he considers intolerable. The specific characteristics of this proposal are set out in Table 4. In recent months, the political debate about a dignified death in Spain has been significantly fuelled. While this is not the first time this debate has reached the Congress of Deputies, various political parties have recently tabled motions to address end-of-life conditions, including the decriminalization of euthanasia in such a motion.1-3 We searched Medline/PubMed, EMBASE and the Cochrane Library for studies that included in their title or abstract the descriptors `euthanasia` or `assisted suicide` and `legislation` or `law` between 2002 and the end of 2020. What is the purpose of the law? Can euthanasia be refused? Is it covered by social security? From Legálitas, they provide answers to the most important questions raised by this law. Law 41/2002 regulating the autonomy of patients and the rights and obligations with regard to clinical information and documentation19, which drew up the above-mentioned Oviedo20 Convention in Spain, adequately reflects these aspects. Every person or patient has the right to receive truthful information about their process and disease, to refuse treatment, to limit therapeutic effort and to choose between available options. The principle of patient autonomy in the process of death can be articulated by informed decision-making appropriate at that time or by carrying out a DVA. Various regional regulations22 have made it possible to develop and implement them, but there is a need to further advance and improve advance care planning, as well as knowledge of the register of living wills and its documents and its accessibility, both by citizens themselves and by the professionals who visit it14. In some situations, given his fragile situation, the patient does not have the ethical competence to make such decisions. In such a case, it is necessary to ask if there is a manifestation of your decision in a registered manner, which has been previously formulated in a living will document (DVA) or a living will.
As the data show, a large majority of people facing the end-of-life process do not have such a document14, which, in a situation of ethical incompetence, confers freedom of choice on the family or its legal representative. Study selection The research revealed 1,647 studies and after screening, 663 were assessed, of which 30 were included in the review. We rejected studies that contained only opinions or did not provide data on euthanasia or assisted suicide in countries where they are regulated. Proposal for an organic law on euthanasia by the Podemos faction (rejected by congress in March 2017) In Spain, there are currently 3 different proposals for an organic law, presented by different political groups, related to the end-of-life process. The Citizens` Group presented the “legislative proposal on the rights and guarantees of the dignity of the person before the last process of his life”, while the Socialist Group presented the “legislative proposal regulating human rights before the last process of life”. Both bills are essentially consistent with what is regulated regionally, taking into account palliative sedation and the pain phase, rather than including universal nuances such as the requirement for professionals to consult the register of living wills before a patient who is actually unable to work, or the right to individual placement and family and spiritual support. More importantly, they contain the deletion of point 3 of the wording of Article 11 of the Patients` Autonomy Act (Table 3), thus omitting the mention of lex artis and, in the case of citizens, adding the right of professionals to conscientious objection against the legal obligation to respect the will. the patient`s values, beliefs and preferences in clinical decision-making (Article 15).