The Spain that does not want to help people die is made up of at least 9,384 health workers who have registered in the regional registers of objectors to the application of the euthanasia law, according to data collected by EL PAÍS in all communities.
This amount represents 1.3% of the around 700,000 collegiate professionals who can take advantage of the conscience clause (among doctors, nurses or pharmacists), although the uneven distribution of objectors reflects that the right is not being established at the same rate in all communities.
Spain became in March 2021 the fifth country to regulate euthanasia through a law.
The norm entered into force on June 25 of that year, and 12 months later at least 172 cases had been registered and a great inequality between the different territories.
On the second anniversary of the law's passage, that hasn't changed.
For example, in the Balearic Islands they have not yet developed the register of objectors to the benefit.
"No one can force me to do something that is repugnant to the depths of my being," explains the pharmacist Eva María Martín, president of the National Association for the Defense of the Right to Conscientious Objection, and an objector herself.
“The objection is not from the right or the left, as they make us see, but rather has to do with the defense of life and the dignity of people.
It is the Hippocratic oath, which teaches us to save lives, to heal, and, when we cannot, to accompany and alleviate pain, ”she continues.
"For this reason, euthanasia goes against the foundations of our vocation," she adds.
And she concludes: “The reality is that there are many more objectors than those 9,000 who are already on the register, I dare say many more, the majority.
Professionally, signing up can mark you, corner you according to some ideologies that are in power.
And many do not see the need to sign up, because it is something that is implicit in our vocation, that ours is to save lives.
Let whoever wants to do it sign up."
"I am a conscientious objector, but I am not on any registry," agrees Dr. Manuel Martínez-Sellés d'Oliveira, president of the Madrid College of Physicians.
"That signing up for a blacklist that can later be used by the ministries to discriminate against professionals, for example in the renewal of their contracts, is a mistake," he reasons.
“I ran for president [of the Association] mainly for this reason, and our candidacy gathered more votes than the other meetings [it won with 6% of the votes and a participation of 13% of the members], so I have few doubts that most doctors are against euthanasia”, he adds.
And he concludes: "The doctor who practices euthanasia goes against the essence of medicine, and the professional code of ethics."
The possibility that there is a hidden pocket of objectors is accepted by all professionals.
Among those who have activated the conscience clause, the majority are concentrated in the Community of Madrid, where there were 3,119 at the end of 2022, 33% of the total.
Aragón (1,077, 11%) and Andalucía (1,051, another 11%) are the other two regions that have the most requests to be included in the registry.
However, the total of 9,384 only reflects a part of an extremely complex reality: not all those registered will receive a request for euthanasia, nor will all those who are not registered practice it, nor is the registry fixed, since you can enter and get out of it at will, even depending on the case or the patient.
Demonstration outside the Congress of Deputies the day the plenary session began the process for the approval of the euthanasia law. Olmo Calvo
“It is absurd to think that euthanasia has been considered or is going to be considered for those 9,000 objectors,” says Dr. Fernando Marín, vice president of the Right to Die with Dignity Association.
“There have never been even that many people who have seriously considered it,” he continues.
"They are there for ideology, to testify that they are against the law, although within the most conservative current of the profession, it is even proposed that they not sign up for any list," he adds.
"There is an attempt to use the objection politically, but it will not be relevant to the provision, because the support of the profession for law enforcement is equal to that of society."
Even so, these two years of implementation of the right to a dignified death have been accompanied by true dramas.
EL PAÍS has already explained, for example, the tragedy of a Sevillian suffering from terminal cancer who ended up committing suicide after taking 10 days to find a referral doctor (a process that should not take more than 48 hours), and almost a month to contact a consulting physician.
That happened in July 2021. The law was already in force.
Two months later, in September, a patient went to her doctor's office at the Gómez Ulla hospital in Madrid and asked her to help her die.
She had suffered from a chronic incurable musculoskeletal pathology for 14 years, aggravated by her intolerance to opioids.
The doctor told her that she was, but 48 hours later she phoned her to tell her that she had declared herself a conscientious objector.
The law establishes that in these cases another doctor must be appointed to examine the patient and assess whether he meets the requirements established by the norm.
But she complained that she only got silence.
A few days later, this woman, who had told her case in EL PAÍS under the condition that her name never be revealed, booked a room in a hotel in Madrid and took her own life.
Manuel Martínez-Selles, president of the Madrid College of Physicians, in the courtyard of the organization's headquarters.
Jaime Villanueva
"The objectors have had a negative influence, promoting other professionals to ignore euthanasia, for other reasons," says Marín.
"The beginnings have been hard for some people, who have died from their illness," she laments, blaming the number of objectors for problems applying the benefit.
The territorial imbalances in the implementation of the law are clear.
Thus, in the first year of application of the norm, Andalusia had carried out six times fewer euthanasias than Catalonia, despite having a million more inhabitants, and less than half that of the Basque Country, despite quadrupling its population.
"9,000 is a very high number of objectors for a law that has been in force for a year and a half," says Dr. Álvaro Gándara, a member of the Madrid Bioethics Association, an organization that considered that the new law would have "negative" consequences. ” when it was approved.
“People are afraid to face such a request, and use the registry as a defensive weapon,” he adds, though he doubts the accuracy of that data set.
“Of the doctors that are signed up, how many are likely to receive a request of this type?
Because many will never receive it and, even so, they sign up, like a radiologist, ”he argues.
“So over time, registration is only going to increase.
And that is why I have defended that a record be made of those who are going to give this benefit ”.
As a source from the Health Department of the Community of Madrid said, "those who sign up for the register of objectors are professionals who have wanted to proactively declare their conscientious objection, which does not mean that the rest practice euthanasia."
Varied specialties
The professionals who have signed up for the different regional registries come from a variety of specialties.
The majority are doctors [of any specialty, such as radiologists, cardiologists...] and nurses, but there are also clinical psychologists and even pharmacists, since the manual of good practice for the provision, published by the Ministry of Health, specifies that these The latter will be able to register "in the event that the magisterial formulation of any of the medications to be administered within the process of aid in dying is necessary, and in the preparation of medication kits."
Relying on the data protection law, all communities avoid detailing where these professionals work, and most even refuse to disaggregate to which specialties they belong.
In the seven autonomies that do provide these data, doctors clearly predominate.
At least at the time when the communities provided the statistics.
Thus, among the 1,077 objectors from Aragon there are 872 doctors, 194 nurses and 9 pharmacy workers.
Of the 371 in the Basque Country, 310 are doctors, 55 nurses, 5 psychologists and 1 works in a pharmacy.
Of the 260 in Asturias, 209 are doctors and 51 nurses.
Of the 239 in Cantabria, 221 are doctors and 18 nurses.
Of the 200 in the Canary Islands, 178 are from Medicine, 21 from Nursing and one from Pharmacy.
Of the 167 in Catalonia, 144 are doctors, 20 nurses, 2 clinical psychologists and 1 is a pharmacist.
But everything can still change: the Constitutional Court began the debate on Tuesday in plenary session on the appeal raised against the euthanasia law by Vox, against which the PP has also appealed.
With information from
Beatriz Olaizola, Mercedes Pedreño, Ferran Bono, Mikel Ormazabal, Eva Saiz, Sonia Vizoso, Juan Navarro and Amaia Otazu
.
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