Medical acts at the end of life and death
DOI:
https://doi.org/10.11606/issn.2316-9044.rdisan.2025.218626Keywords:
Assisted Suicide, Euthanasia, Medical Acts, Medical Liability, Palliative CareAbstract
Aid at the end of life and dying includes the use of therapeutic methods or procedures such as palliative care, euthanasia, and assisted suicide. The recognition of these procedures as medical acts is a major point of debate. This article specifically examines the classification of these procedures as medical acts within the legal frameworks of Spain and Colombia. It aims to demonstrate that recognizing aid at the end of life and dying as medical acts involves substantial legal implications, particularly in terms of medical liability and ethical considerations. To analyse the positions in favour and against, a bibliographic review was conducted. Firstly, such methods have been subject to progressive medicalisatio n because they have mainly occurred in healthcare contexts. Secondly, medical professionals must consider the possibility of allowing patients to die with dignity in order to fulfil their purpose of helping people with serious, incurable bodily injuries, illnesses, and chronic disabling conditions for which there is no possibility of cure or measurable improvement. Finally, when such methods and procedures are considered medical acts within the doctor–patient relationship, certain rights and obligations subject to legal regulations can be established. This is the first time that, in legal dogmatics, medicalisation is linked to medical acts, especially those at the end of life and death. Moreover, medical acts at the end of life and death are associated with a regime of professional and legal liability, making it possible to examine these acts in light of medical liability.
Downloads
References
ALONSO, Juan Pedro. Palliative care: between humanization and medicalization of the end of life. Ciência & Saude Coletiva, Rio de Janeiro, v. 18, n. 9, p. 2541-2548, 2013. Available at: https://doi.org/10.1590/S1413-81232013000900008. Accessed on: 17 May 2024.
ARRUEGO, Gonzalo. On the relationship between the fundamental right to life and assisted death. BioLaw Journal – Rivista Di BioDiritto, Trento, n. 3, p. 287-301, 2020. Available at: https://doi.org/10.15168/2284-4503-707. Accessed on: 17 May 2024.
BEDOYA HERNÁNDEZ, Mauricio Hernando; BUILES CORREA, María Victoria. The medical act as ethics in the relationship. Iatreia, Medellín, v. 22, n. 1, p. 47-54, 2012. Available at: https://doi.org/10.17533/udea.iatreia.13957. Accessed on: 17 May 2024.
BESIO ROLLERO, Mauricio. About the medical act. Cuadernos de bioética, Madrid, v. 14, n. 50, p. 25-38, 2003. Available at: http://aebioetica.org/cuadernos-de-bioetica/archivo-historico/2003/n-50-enero-abril.html. Accessed on: 17 May 2024.
BORSATTO, Alessandra et al. A medicalização da morte e os cuidados paliativos. Revista Enfermagem UERJ, Rio de Janeiro, v. 27, e41021, 2019. Available at: https://doi.org/10.12957/reuerj.2019.41021. Accessed on: 17 May 2024.
BUNDESVERFASSUNGSGERICHT. 2 BvR 2347/15. Rn. 1-343, 26 Feb. 2020. Available at: http://www.bverfg.de/e/rs20200226_2bvr234715.html. Accessed on: 17 May 2024.
CÁMARA VILLAR, Gregorio. The regulation of euthanasia and assisted suicide in the world. General and comparative overview. Anuario de derecho eclesiástico del Estado, Madrid, v. 37, p. 399-464, 2021. Available at: https://dialnet.unirioja.es/servlet/articulo?codigo=8132101. Accessed on: 17 May 2024.
CASA MADRID MATA, Octavio. The medical act and health law. In: TENA TAMAYO, Carlos; CASA MADRID MATA, Octavio. (ed.). Medicina asertiva, acto médico y derecho sanitario. Mexico City: Editorial Alfil, 2008.
CASTILLO FREYRE, Mario. About obligations and their classification. Themis: Revista de Derecho, Lima, n. 66, p. 209-220, 2014. Available at: https://dialnet.unirioja.es/descarga/articulo/5081187.pdf. Accessed on: 17 May 2024.
COLOMBIA. Corte Constitucional. Sentencia C-164/22. Bogotá: Corte Constitucional, 2022. Available at: https://www.corteconstitucional.gov.co/relatoria/2022/c-164-22.htm. Accessed on: 20 Jan. 2025.
COLOMBIA. Corte Constitucional. Sentencia C-233/21. Bogotá: Corte Constitucional, 2021a. Available at: https://www.corteconstitucional.gov.co/relatoria/2021/c-233-21.htm. Accessed on: 20 Jan. 2025.
COLOMBIA. Corte Constitucional. Sentencia C-239/97. Bogotá: Corte Constitucional, 1997. Available at: https://www.corteconstitucional.gov.co/relatoria/1997/c-239-97.htm. Accessed on: 20 Jan, 2025.
COLOMBIA. Ministerio de Salud y Protección Social. Resolución 971/2021. Bogotá: Ministerio de Salud y Protección Social, 2021b. Available at: https://www.alcaldiabogota.gov.co/sisjur/normas/Norma1.jsp?i=114617. Accessed on: 20 Jan, 2025.
DUGDALE, Lydia S. Therapeutic Dying. The Hastings Center Report, Hoboken, v. 44, n. 6, p. 5-6, 2014. Available at: https://doi.org/10.1002/hast.379. Accessed on: 17 May 2024.
ECHEVERRÍA, Carlos et al. Euthanasia and medical act. Revista Médica de Chile, Santiago de Chile, v. 139, n. 5, p. 642-654, 2011. Available at: https://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872011000500013&lng=en&nrm=iso&tlng=en. Accessed on: 17 May 2024.
GALATI, Elvio. Euthanasia and the medicalization of death from a complex legal perspective. Revista Latinoamericana de Bioética, Bogotá, v. 18, n. 1, p. 69-86, 2018. Available at: https://doi.org/10.18359/rlbi.1833. Accessed on: 17 May 2024.
GAMBLIN, Vincent et al. Sedation or the limits of palliative care – ethical questions. Ethics, Medicine and Public Health, Amsterdam, v. 3, n. 3, p. 343-348, 2017. Available at: https://www.sciencedirect.com/science/article/pii/S2352552517300774. Accessed on: 17 May 2024.
GEMPELER RUEDA, Fritz Eduardo. The right to die with dignity. Universitas Medica, Bogotá, v. 56, n. 2, p. 178-185, 2016. Available at: https://revistas.javeriana.edu.co/index.php/vnimedica/article/view/16356. Accessed on: 17 May 2024.
GIRALDO GÓMEZ, Luis Felipe. The non-contractual nature of civil liability for damages caused in the provision of public health services in Colombia. Estudios Socio-Jurídicos, Bogotá, v. 24, n. 1, p. 267-298, 2022. Available at: https://doi.org/10.12804/revistas.urosario.edu.co/sociojuridicos/a.10148. Accessed on: 17 May 2024.
GUERRERO QUIÑONES, Jose Luis. Physicians’ Role in Helping to Die. Conatus – Journal of Philosophy, Athens, v. 7, n. 1, p. 79-101, 2022. Available at: https://doi.org/10.12681/cjp.29548. Accessed on: 17 May 2024.
GUZMÁN MORA, Fernando. The medical act: Basic considerations. Medicina, Bogotá, v. 23, n. 1, p. 8-13, 2001. Available at: https://revistamedicina.net/index.php/Medicina/article/view/55-2. Accessed on: 17 May 2024.
HODELÍN TABLADA, Ricardo. The principle of double effect in the sedation of terminally ill patients. MEDISAN, Santiago de Cuba, v. 16, n. 6, p. 949-959, 2012. Available at: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30192012000600015&lng=es&tlng=es. Accessed on: May 17, 2024.
JARAMILLO, Carlos Ignacio. Derecho privado: estudios y escritos de derecho patrimonial. Bogotá: Pontificia Universidad Javeriana, 2023. t. IV, v. 3.
KARSOHO, Hadi; et al. Suffering and medicalization at the end of life: The case of physician-assisted dying. Social Science & Medicine, Amsterdam, v. 170, p. 188-196, 2016. Available at: https://www.sciencedirect.com/science/article/pii/S027795361630569X?pes=vor. Accessed on: 17 May 2024.
MERCHÁN PRICE, Jorge. Euthanasia is not a medical act. Persona y Bioética, Chía, v. 12, n. 1, p. 42-52, 2008. Available at: https://personaybioetica.unisabana.edu.co/index.php/personaybioetica/article/view/959. Accessed on: 17 May 2024.
MOLINA-RICAURTE, Carlos Jesús. Law on dignified death in Colombia: challenges for the realization of fundamental rights. In: OLIVERO, Sandra. (coo.). Las identidades analizadas a través de las segregaciones histórico-culturales. Madrid: Dykinson, S.L., 2024. p. 329-343.
NAVARRO RUBIO, María Dolores; MUÑIZ, Giovanna Gabriele; JOVELL FERNÁNDEZ, Albert J. Patient rights in perspective. Atención primaria, Amsterdam, v. 40, n. 7, p. 367-369, 2008. Available at: https://doi.org/10.1157/13124131. Accessed on: 17 May 2024.
OYA MÁRQUEZ, Alberto. Is medicalization a negative phenomenon? An analysis of the consequences often attributed to medicalization. Daimōn, Murcia, n. 71, p. 7-18, 2017. Available at: https://doi.org/10.6018/daimon/230801. Accessed on: 17 May 2024.
PACHECO GÓMEZ, Alejandro. Legitimación del acto biomédico. Mexico City: Editorial Alfil, 2011.
PARADELA LÓPEZ, Miguel; JIMA-GONZÁLEZ, Alexandra. Analyzing the Spanish Euthanasia Law: Achievements and inconsistencies of the legal assistance to die. Revista de Bioética y Derecho, Barcelona, n. 58, p. 147-164, 2023. Available at: https://revistes.ub.edu/index.php/RBD/article/view/39990. Accessed on: 17 May 2024.
PARRA SÁEZ, Jesús. The medicalization of life and contemporary society: origin, participants and consequences. Bajo Palabra, Madrid, n. 22, p. 221-238, 2019. Available at: https://doi.org/10.15366/bp2019.22.011. Accessed on: 17 May 2024.
RIVERA ALVARADO, Martha Isabel. What is understood by the responsibility of the medical act? A reflection based on the biolegal perspective. Escritos, Medellín, v. 22, n. 48, p. 123-142, 2014. Available at: https://revistas.upb.edu.co/index.php/escritos/article/view/742. Accessed on: 17 May 2024.
ROMEO CASABONA, Carlos María. The organic law governing euthanasia and the adaptation of the criminal code. BioLaw Journal – Rivista Di BioDiritto, Trento, n. 2, p. 283-314, 2021. Available at: https://doi.org/10.15168/2284-4503-823. Accessed on: 17 May 2024.
RUIZ-RICO RUIZ, Catalina. The fundamental right to euthanasia and its constitutional problems in Spain. Revista de Bioética y Derecho, Barcelona, n. 58, p. 129-146, 2023. Available at: https://revistes.ub.edu/index.php/RBD/article/view/39850. Accessed on: 17 May 2024.
SANTOS BALLESTEROS, Jorge. Responsabilidad civil. Bogotá: Editorial Temis S.A., 2023. t. II.
SEOANE, José-Antonio. Legislative Debates on Death with Dignity and Euthanasia. An Approach to the Spanish Situation. In: OLIVER-LALANA, A. Daniel. (ed.). Debating Laws Studies on Parliamentary Justification of Legislation. Switzerland: Springer, 2024. p. 85-113.
SPAIN. Ley Orgánica 3/2021, de 24 de marzo, de regulación de la eutanasia. Boletín Oficial del Estado: Madrid, 25 Mar. 2021. Available at: https://www.boe.es/boe/dias/2021/03/25/pdfs/BOE-A-2021-4628.pdf. Accessed on: 20 Jan. 2025. p. 34037.
TELLEZ COBO, Víctor Manuel; HERNÁNDEZ MAHECHA, Héctor Hernando. The role of liability in medical law. In: MURILLO, Edwin; MARÍN, Jennifer Stella; RINCÓN, Gerard. (ed.). Fundamentos de derecho médico. Cali: Universidad Santiago de Cali, 2021. p. 295-354.
VALDÉS, Erick. Biolaw, genetic damage and fourth generation human rights. Boletín Mexicano de Derecho Comparado, Mexico City, n. 144, p. 1197-1228, 2015. Available at: https://doi.org/10.22201/iij.24484873e.2015.144.4964. Accessed on: 17 May 2024.
VARGAS, Camilo Andrés. The medical act in the Latin American region. Frónesis, Maracaibo, v. 29, n. 3, p. 205-233, 2022. Available at: https://produccioncientificaluz.org/index.php/fronesis/article/view/39461. Accessed on: 17 May 2024.
VILLARROEL SOTO, Raúl. Bioethics and reciprocity in the recognition of rights and duties. Acta Bioethica, Santiago de Chile, v. 15, n. 1, p. 79-86, 2009. Available at: http://dx.doi.org/10.4067/S1726-569X2009000100010. Accessed on: 17 May 2024.
ZAMAN, Mehreen et al. What would it take to die well? A systematic review of systematic reviews on the conditions for a good death. The Lancet Healthy Longevity, Amsterdam, v. 2, n. 9, p. 593-600, 2021. Available at: https://www.sciencedirect.com/science/article/pii/S2666756821000970?pes=vor. Accessed on: 17 May 2024.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Journal of Health Law
This work is licensed under a Creative Commons Attribution 4.0 International License.
The Revista de Direito Sanitário/ Journal of Health Law adopts the conditions of the Creative Commons Attribution 4.0 Internacional. This license allows to share - "copy and redistribute the material in any medium or format for any purpose, even commercially" and adapt - "remix, transform, and build upon the material for any purpose, even commercially." Details at: https://creativecommons.org/licenses/by/4.0/deed.en
