Case 22/2003 (IV.28)

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The Court of Hungary received several petitions regarding the right of patients suffering from terminal illnesses to end their lives with dignity and consolidated the petitions into a single judgment.

One petition asked the Court to declare unconstitutional and annul the last sentence in Section 43, paragraph (2) of Act II of 1972 on Healthcare. The petitioners claimed that Hungarian law was unconstitutional because it defined the criminal offense of homicide and set punishment without taking into account the fact that physician-assisted suicide is committed at the request of patients, thereby violating patients’ right to human dignity granted under Article 54 paragraph (1) of the Constitution.

Another petitioner suffering from a serious illness asked the Court to establish that prohibiting his physician to provide substances that could be used to terminate his life violateed his right to human dignity.

The Court rejected the petition claiming that Act CLIV of 1997 on Healthcare unconstitutionally restricted the right to self-determination of patients with terminal illness by not allowing the termination of their lives through physicians’ active intervention and assistance. The Court reasoned that, although the right to human dignity includes both the fundamental right to freedom of self-determination and the fundamental right to one’s physical integrity, the desire of a terminally-ill patient to have his death induced by a physician is beyond the right to self-determination of the patient and cannot be deduced from the general right to self-determination.

The Court held that restricting the right to self-determination of terminally ill patients was necessary for the protection of another fundamental right, the right to life, and was therefore justified.

After examining the petitioners’ claim regarding unconstitutional restriction of a patient’s right to self-determination by the provisions of of the Act which have allowed the refusal of life-saving or life-supporting interventions by patients with terminal illness in the case of the fulfilment of certain conditions (i.e. making the refusal in a public deed or private deed of full probative force, or in the presence of two witnesses if the patient cannot write, suffering from the terminal illness that would lead to death within a short time even with proper medical care), the Court rejected the petition as unfounded. The Court reasoned that the provision should be assessed on the basis of the state of medical knowledge rather than on the basis of the patient’s subjective feelings about this period of time. The Court also held that it is clear from Section 20 paras (3) and (4) of the Act CLIV of 1997 on Healthcare that it is not in the arbitrary discretion of the medical committee, and it is not based on their empathy about the patient’s situation.

“In the opinion of the Constitutional Court, the fact that the Act only partially allows the enforcement of terminally ill patients’ right to self-determination with respect to ending their lives in a manner reconcilable with their human dignity, while this right is partially restricted, is a manifestation of the obligation of the State to protect life in accordance with Article 8 para. (1) of the Constitution.” Page 41.

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