Surge in Euthanasia Requests in Spain: A Deep Dive into the 2023 Annual Report
Since the enactment of the law regulating euthanasia in Spain in June 2021, there has been a significant rise in the number of requests for assisted dying. According to the latest annual evaluation report from the Ministry of Health, a total of 1,515 requests had been processed by the end of 2023. The numbers have steadily increased from 173 in 2021 to 576 in 2022, and dramatically to 766 in 2023, indicating a staggering 329% increase in the last year alone.
Out of the 766 requests received in 2023, 76% were accepted, leading to 334 euthanasia provisions, while 188 requests were rejected. Following these rejections, 78 appeals were filed, 32 of which were resolved in favor of the applicants. Since the law's introduction, a total of 667 euthanasia provisions have been completed across the country.
The data also reveals a troubling trend: while the initial requests increased from 72 in the first year to 459 last year, the rate of requests made through advance directive documents has also risen, from just 3 in 2021 to 22 in 2023. Notably, of the accepted requests in 2023, 21 were revoked by the individuals and 33 were postponed. Alarmingly, 190 applicants died during the process, with an average waiting period of 30 days between their request and death.
When analyzing the data by autonomous community, Catalonia had the highest number of requests with 219, out of which 94 were executed. Madrid followed with 89 requests, and 35 were granted. Other regions, such as the Canary Islands and the Basque Country, also accounted for significant numbers of requests, showcasing geographical variations in the uptake of euthanasia provisions.
Demographically, the majority of applicants were aged between 70 and 79 years, constituting 28% of the requests. A substantial number were aged 80 and above, while a small fraction were under 30. The most common illnesses prompting requests for assisted dying were oncological and neurological issues, as well as severe multipathology. It is noteworthy that a large majority of individuals had the capacity to request euthanasia initially, but many were at imminent risk of losing that capacity.
The euthanasia process begins with a written request made before a healthcare professional, who must confirm the applicant's mental capacity. On average, the total process resolution time is less than 70 days, and the average time from the request to the actual performance of assisted dying is approximately 67 days.
Research into the setting of these provisions reveals that 47% were conducted in hospitals, while 44% occurred in the patients' homes. Interestingly, the revocation rate remains low at under 3%, and the requests for postponing euthanasia after approval also accounted for just 4% of total requests.
Additionally, the report highlights that between 2021 and 2023, an impressive number of 91 organ donations were facilitated by individuals who chose to donate their organs post-provision. Statistics show that 95% of individuals preferred the healthcare team to administer the medication, with only a handful opting for self-administration.
As the evaluation period draws to a close, it raises profound ethical discussions surrounding euthanasia, organ donation, and individual autonomy, calling for continued dialogue as society navigates these complex issues.
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