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The new president of the Madrid Medical Association, Manuel Martínez-Sellés, harshly criticizes the new euthanasia law in a country where palliative care is still very little developed.
Congress has approved the euthanasia law, why is it opposed? This new law is going to make us the exception in Europe, where right now euthanasia is only legalized in the Benelux.
That should be food for thought by now.
In the majority of neighboring countries it is considered
illegal to kill a patient.
Euthanasia goes against the Hippocratic Oath and the medical code of ethics.
Furthermore, the World Medical Association has clearly and explicitly condemned it.
Why do you consider it so negative?
Destroy the doctor-patient trust relationship.
Today, when a patient goes to a hospital, he is sure that what they are going to do to him is something good for him.
With this new law, we are going to lose this relationship.
Well, the doctor is not going to do anything that the patient has not asked.
We'll see.
In Holland, they are doing it.
There are patients who are not at their best.
Advanced diseases impair cognitive ability.
When the law is passed, there may be uncertainty as to whether it is the child who wants the inheritance.
I hope someone reads this interview 10 years from now.
I hope I'm wrong, but euthanasia is being applied to patients who have not requested it.
What is happening in Holland?
Euthanasia is only legalized in the Benelux, Canada and Colombia.
In the Netherlands, euthanasia began to be used in very specific cases, but as time has passed "the sliding slope" occurs and those cases have been falling.
Today, in the Netherlands, they are applying euthanasia to the elderly with dementia, the mentally ill and children with disabilities, that is, patients who due to their own clinical condition do not have the capacity to request it.
The husband of María José Carrasco, the only one prosecuted for euthanasia, told El MUNDO the other day that his wife would spend six hours in a row screaming in pain.
That is totally inhumane and means that this woman did not have adequate palliative care.
With the advances in medicine, this situation should not occur in any case.
In fact, there is an extreme resource that we apply on a daily basis, which is palliative sedation.
When is it administered?
If I have a patient who is in a lot of pain or is unable to control symptoms, I can sedate the patient, even at the risk of losing consciousness.
That has no problem from an ethical point of view.
If the patient dies, that is not euthanasia, but an unwanted side effect.
Carrasco's husband said that they gave her large amounts of medicine, but they were not able to calm her pain.
I insist that they could have given him palliative sedation.
That it would have ended in death.
Or not.
It does not have to be irreversible.
But she wanted to die.
This patient requests that she does not want to be in that situation and will have to give her treatment to prevent her from being in that situation.
What do we do when someone is going to commit suicide?
We mobilize as a society so that it does not.
We understand that that person has a situation at that moment that is inclining him to do something that is not good for him.
It is surprising that now they do not want to avoid it, but rather that it is facilitated and that they want to force doctors, who are trained to do the opposite, to kill our patients.
Can't the law give a boost to palliative care?
Quite the opposite.
What has been seen in countries where euthanasia has been legalized is a decline in palliative care.
What interest can you have in developing good palliative care or investigating diseases like Alzheimer's if you are going to kill patients who have those diseases?
Euthanasia slows the progress of medicine and palliative care.
In this country, palliative care is very underdeveloped.
Two services are recommended for every 100,000 inhabitants and we have 0.6, that is, we do not even reach half.
What are the consequences of this poor development of palliative care?
That we have many patients who are suffering in the last months of their life and are not being given the proper treatment.
What alternative are you going to offer them now?
They will not be given good palliative care, but the alternative is to kill them.
That is why I say that it will be a great health cut in a country that will be the oldest in the world in less than 20 years.
Let's say then that the law has had broad parliamentary support, but it leaves doctors an important brownish.
To 100%.
It forces them to kill patients because the text is mandatory.
They don't have to force doctors to do something that goes against their profession.
This law has been hastily passed at a time of pandemic when society cannot speak out, without consulting with doctors and against the opinion of the bioethics committee.
What will happen to the doctors who refuse to perform euthanasia?
We will make conscientious objection, but it will be necessary to see what consequences it has.
In the Community of Madrid, there is a lot of job instability and doctors are signing contracts every 6 months.
I am very afraid that this data will reach the Administration and that it may have repercussions when it comes to promoting or renewing contracts.
How are doctors who do not want to euthanize themselves to be protected?
Euthanasia goes against medical ethics, so it will be necessary to see what is done with the doctors who kill their patients, who will be doing something legal, but not ethical.
The World Medical Association has a statement from a year ago that clearly condemns both euthanasia and assisted suicide.
What other problems does the legal text present?
The law also puts something incomprehensible, which is that, from the legal point of view, it is going to be considered a natural death, something that, by definition, is not a natural death.
The law forces us to lie.
It seems very serious to me that euthanasia is legally considered natural death.
How can the law hide that patients are being killed?
Imagine that there are two brothers, one who lives in Madrid and the other in Barcelona, and one tells another that their mother died naturally, when she was euthanized.
Have physicians been consulted during the law-making process?
There has been no debate or dialogue with the doctors.
What does the code of ethics for doctors say in this regard?
It explicitly states that we will not kill our patients, even if they ask us to.
This law forces us to violate our code of ethics.
How do you assess the current situation of the coronavirus epidemic?
I'm very worried.
We now begin to see the effect of Christmas.
We are seeing a very worrying increase in hospital and ICU admissions.
It makes me sad because, in general, the population has been responsible, except for a small percentage.
But if it is 10%, in Madrid, it is a lot of people.
The nurses say that at this rate they will be vaccinating for five years.
It's true.
You just have to do the math.
Either we totally change the way we organize vaccination or we are going to take a long time.
In the UK, more than a million people have already been vaccinated.
What is failing?
I miss that there is a specific program.
You may have to vaccinate outside of business hours and on weekends.
It is hard to understand that we have the vaccines and the population is not being vaccinated.
Are there sufficient means to undertake a mass vaccination campaign?
If there are not, we will have to look for them.
Our lives depend on it If we give priority to vaccination over other interventions, surely there are enough means.
According to the latest data, only 28% of the vaccines received have been given.
This seems like a scandal to me.
That the limiting factor is the health system.
His predecessor in office, Miguel Ángel Sánchez, was very critical of the health management of the Madrid Government and believed that the situation of doctors in health centers was daunting.
I am critical of all administrations.
It is true that even before the pandemic there was a situation of deficit of means in primary care.
At this time, a family doctor has to attend in person, by telephone, carry out tracking tasks, assist at home ... There is a multitasking that is unsustainable in primary care, a key element in the health system.
What was more urgent: equip primary care or build the Isabel Zendal emergency hospital?
That is a good question.
It is difficult for me to speak against a new public hospital in the Community of Madrid.
The opening of a new hospital that can allow a discharge from the other hospitals seems to me, in principle, good news.
Now there is no overflow, although we believe that this third wave is going to be very strong.
But focusing health resources on patients with Covid has an impact on other pathologies.
Which?
For example, the mortality of heart attack patients has doubled because there are delays in testing.
The Isabel Zendal can also be used for many patients who are awaiting endoscopies and imaging tests and do not have coronavirus.
The waiting list for some tests is becoming very worrying.
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