No mercy killing for terminally ill patients, Africa’s doctors resolve

A regional meeting of the World Medical Association (WMA) has ruled out euthanasia and physician-assisted suicide as options available for terminally ill patients in Africa. The Nigerian Medical Association, which hosted a regional meeting of WMA, comprising five national associations from Africa, resolved that mercy killing of any sort as a practice in medicine was […]

A regional meeting of the World Medical Association (WMA) has ruled out euthanasia and physician-assisted suicide as options available for terminally ill patients in Africa.

The Nigerian Medical Association, which hosted a regional meeting of WMA, comprising five national associations from Africa, resolved that mercy killing of any sort as a practice in medicine was “in conflict with the physician’s oath” which prohibits physicians from using medical knowledge to violate human rights and liberties even under threat.

In a communiqué delivered by NMA president, Dr Mike Ogirima, the associations said, physician-assisted suicide and euthanasia “contradict African cultural beliefs and values.”

The resolution came after medical associations explored euthanasia, physician-assisted suicide and palliative care as options in end-of-life issues in health care.

Most African countries have no policies on end-of-life care, apart from Kenya, Nigeria, Zambia and Botswana, which have initiatives in palliative care.

The associations opted for strengthening palliative care instead, calling for national policies, increased funding and creation of national and regional palliative care centres.

“Many African countries are characterized by poor health care institutions, poor health care finances, with very low government budgets for health care, which also affect adversely end-of-life issues and palliative care,” the associations noted.

It is the first time WMA will consider the opinion of African experts on end-of-life issues.

“Other continents have deliberated on issues. The African voice has never heard on this topical issue. It is an opportunity for us to bare our voice. Where do we agree or disagree on these issues,” said Ogirima.

“Never before has it been discussed on African soil. In 100 years, people of African origin may decide to change their belief but the belief now is that we reject euthanasia and physician-assisted suicide.”

“Of course, for those patients that may wish to throw in the towel, we cannot assist them because the law of the country and ethics of the physician does not permit us to take life. It is a topical issue, but as a doctor I cannot help in Nigeria.”

WMA’s question about end-of-life care came after Canada and Netherlands legalized different form of mercy killing and challenged the association’s longstanding policies against euthanasia.

WMA agreed to open up the discussion which has been confined to European and North American countries to include Latin America, Asia and Africa.

“What we want is really to have heard the voices of our colleagues from these parts,” said Otmar Kloiber, secretary-general of WMA, commissioned to hold regional meetings with national medical associations.

He said his meetings, with associations in Latin America and Asia last year and this February with African doctors, show, “We have to put much more effort and focus on palliative care. It is a necessary care for people at the end of life to take away pain, anxiety.

“There are a lot of questions about stopping and ending futile treatments, that may only prolong suffering but not do any good to patient. We need safety and security about when it is ethically correct to stop a treatment, not with the intention to kill a patient, but with the intention not to prolong suffering and prolong a completely unnecessary and futile treatment.

The end-of-life exploration has also exposed need for universal health coverage that includes palliative care.

“It is important that every person be insured for health with a coverage that also provides palliative care, so that all people have a chance to get comforting healthcare at the end of their lives that does not ruin their families and that does not deprive them of resources,” said Kloiber.