The European Court of Human Rights has affirmed the sovereignty of nations to prohibit assisted suicide, ruling 6-1 on Thursday in support of Hungary’s prohibition of the practice.

The decision reaffirms a commitment to preserving life in alignment with international law amid ongoing debates about the ethical implications of euthanasia and physician-assisted suicide. 

“The Court further notes that it has found it justified for Hungary to maintain an absolute ban on assisted suicide,” the ruling states.

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“Furthermore, as mentioned above, the right to refuse or withdraw consent to interventions in the health field is recognised also in the Oviedo Convention, which, in contrast, does not safeguard any interests with regard to [physician-assisted dying]. … The Court therefore considers that the alleged difference in treatment of the aforementioned two groups of terminally ill patients is objectively and reasonably justified.”

In the case of Karsai v. Hungary, Hungarian national Dániel Karsai, a human rights lawyer in an advanced stage of amyotrophic lateral sclerosis (ALS), argued that Hungary’s ban on assisted suicide infringed on personal freedoms and dignity.

The legal advocacy group ADF International, alongside the U.K.-based NGO Care Not Killing, intervened in this case, arguing that the country’s prohibition is consistent with Hungary’s obligations under the European Convention on Human Rights to protect life. 

Jean-Paul Van De Walle, legal counsel for ADF International, praised the court’s decision.

“We applaud today’s decision by the European Court of Human Rights, which upholds Hungary’s essential human rights protections,” he stated. “Although we deeply empathize with Mr. Karsai’s condition and support his right to receive the best care and relief possible, it is clear from other jurisdictions that a right to die quickly becomes a duty to die.”

ADF International contends that the preservation of legal prohibitions on assisted suicide is essential to protecting vulnerable citizens. The court echoed this sentiment, stating that there is “no basis for concluding that the member States are thereby advised, let alone required, to provide access” to assisted suicide.

The court acknowledged the inherent dangers of removing legal protections for life, noting that such removal can lead to pressures on vulnerable individuals to end their lives due to fears of being a burden.

The ruling reaffirms the decision made in the 2002 ECHR case, Pretty v. U.K., which also upheld a ban on assisted suicide, citing the need to prevent exploitation and abuse of the vulnerable.

The judgment also discussed the role of medical and palliative care, stating that “it is part of the human condition that medical science will probably never be capable of eliminating all aspects of the suffering of individuals who are terminally ill.”

The court emphasized a humane approach to palliative care, guided by compassion and high medical standards to manage such vulnerabilities.

Globally, the legalization of assisted suicide remains highly contentious, with only a few countries permitting the practice. The court’s ruling notes that despite the trend of countries legalizing or decriminalizing assisted suicide, the majority of Council of Europe member states continue to prohibit and prosecute assistance in suicide.

Van De Walle asserts that legal “safeguards” intended to prevent abuse have proven insufficient, as evidenced in various countries where assisted suicide is legal. Instances of abuse include euthanasia of young adults for incurable depression and elderly individuals for symptoms related to aging, reflecting the slippery slope of such legal frameworks.

In 2012, the Parliamentary Assembly of the Council of Europe issued Resolution 1859, stating, “Euthanasia, in the sense of the intentional killing by act or omission of a dependent human being for his or her alleged benefit, must always be prohibited.”

“Once we as a society open the doors to intentional killing, there is no logical stopping point,” Van De Walle further remarked. “How do we distinguish between the person we talk down from the bridge and the person we let die at the hands of their doctor? The state is obligated to protect the fundamental value of human life. We should not set in motion legal changes that undermine this obligation to the detriment of all of society.”