Should Rwanda consider legalizing Euthanasia?

By Esther Muhozi
On 20 January 2024 at 07:14

Minka (not real name) is a woman who has witnessed her brother’s suffering for the past four years. His pain became so unbearable that he pleaded with her to end his life, rather than endure the agony of watching his children succumb to poverty.

The ordeal began one day when he urgently summoned her to his home. Despite being immersed in her medical studies in Gitwe, and with only the two of them left in their immediate family, she immediately boarded a bus to be by his side.

Tears welling in her eyes, she recounts, "Since that day, I have never seen my brother live his life again."

Upon arriving, she found him at home, lying on his couch, complaining of an excruciating headache. As an engineer, they initially attributed it to stress from ongoing projects. However, despite resting, the headache persisted. Months passed, and his condition deteriorated—weakness, numbness, loss of appetite due to the fear of vomiting, decreased coordination, seizures, and significant weight loss.

At only 35 years old, the seriousness of his symptoms puzzled both siblings. Minka, studying medicine, recognized the severity and sought a different hospital for a second opinion, as previous attempts had failed to diagnose the ailment.

Regrettably, the results were disheartening, revealing a critical case of Brain Damage. Years have passed, and her brother struggles to articulate his own name, stuttering and constantly in tears.

The disease has profoundly impacted them, forcing Minka to abandon her medical studies. She now devotes herself to caring for her brother, who, was her sole source of support for her education.

His two children, Nael and Naella (names withheld), had to be moved from reputable schools to others. His house and belongings were sold when he was taken to India for three months, yet there was no improvement.

Not to mention, his wife left him with their two young children, departing under the pretext that she had married a healthy and wealthy man.

"Life has been challenging for everyone, especially for him. He began pleading with me and anyone who visited him to let him die in peace. Despite witnessing his suffering, we knew the decision was not ours to make; it is considered a crime in Rwanda," she states.

When asked by IGIHE what she would do if euthanasia were not illegal, she expressed, "If this were possible, we would ask the doctors to allow him to rest in peace. Unfortunately, the doctors stated it’s not within their authority; it goes against ethical principles and is prohibited by law. Honestly, if it were up to me, I love my brother dearly, and I would do anything in my power to grant him peace."

The Article 109 of Law Nº68/2018, dated 30/08/2018, determining offenses and penalties in general, specifies that euthanasia is considered an offense. It is defined as ending a patient’s life upon the patient’s request to relieve unbearable suffering caused by an incurable illness. The offender, upon conviction, faces imprisonment for a term ranging from three (3) to five (5) years.

When IGIHE reached out to a medical doctor, Kalisa Desire working at Ndengera Polyclinique in Rubavu District, he provided another perspective on euthanasia.

Dr. Kalisa clarified that euthanasia encompasses two distinct types: active and passive.

Active euthanasia involves causing the death of a patient through direct intervention, such as administering a lethal dose of medication. This form is sometimes referred to as "aggressive" euthanasia. On the other hand, passive euthanasia entails deliberately allowing a patient to pass away by refraining from providing artificial life support, such as withholding the use of a ventilator or feeding tube.

Dr. Kalisa emphasizes that assisting someone in ending their life is against the medical oath to "do no harm."

However, if it was up to him, he would legalize passive euthanasia, as there are instances where patients, initially deemed hopeless, have recovered.

Dr. Kalisa recounts a recent case where a severely ill patient was transferred to Ndengera Polyclinique from another hospital with a prognosis of imminent death. Dr. Kalisa adjusted the prescription, and the patient is now recovering, having been discharged and showing improvement.

If euthanasia was legal, both the patient’s wishes and the family’s requests could have been fulfilled, potentially denying him the chance to be alive today. This prompts contemplation that life, as ordained by God, holds more profound significance.

Religious experts contribute a thought-provoking perspective on euthanasia. A pastor in his early fifties holding doctorate Theology, who has been serving since 1998, asserts that euthanasia is not merely a crime but also a sin.

“There is only one creator God, and only He has the power to take away a human being’s life. Only He decides who lives and who dies in His own perfect time. Given this, accepting euthanasia goes against Christian beliefs as it is considered killing, which is a crime against the Lord,” he explains.

He further elaborates, “A person may appear to be on their last breath, experiencing immeasurable pain with an incurable disease, but if God is not done with them yet, we have no right to end their life. He himself has witnessed people living after everyone thought they were destined to die. Let us leave such matters to God and refrain from committing evil.”

On the other hand, some individuals, like Alice, view euthanasia as a personal decision, akin to the right an individual has in making life choices. The law, as suggested, should acknowledge that the patient is enduring unbearable suffering with an incurable disease, making it logical to grant them the right to rest.

Some argue that Rwandan laws should legalize euthanasia with regulated conditions, such as the requirement that the person be an adult and willing to sign with two or three witnesses, including family members or partners.

Alice suggests that in the case of minors, consultation with parents and an elder sibling should be mandatory.

“Medical assistance in dying is a complex and deeply personal issue. The Government of Rwanda should be committed to ensuring that laws reflect Rwandans’ needs, protect those who may be vulnerable, and support autonomy and freedom of choice,’’ she advocates.

Contrastingly, countries like Belgium and Canada have legalized euthanasia, terming it Medical Assistance in Dying (MAID). In Canada, it is extended to people with mental illness under specific conditions.

In the face of diverse ideas and legal intricacies, the controversy over euthanasia in Rwanda remains unresolved. While some argue for inclusive deliberations and societal consensus, others emphasize the need for individual autonomy and freedom of choice.

However, the question persists: Should euthanasia be legalized in Rwanda, and if so, how can it be ethically and responsibly regulated? As the debate continues, the stories of individuals like Minka and her brother underscore the urgency of addressing this complex and deeply personal issue.

Euthanasia refers to the painless ending of a patient's life who is enduring an incurable and agonizing disease or is in an irreversible coma.