Deliberative dialogue on euthanasia in girls, boys and adolescents. Prequel to the Cabildo Ciudadano (Citizen Council) carried out in Colombia

Abstract

Background: To date, there is a lack of published information on the utilization of the Deliberative dialogue methodology and the right to a dignified death in minors under 18 years of age in Colombia and Latin America.

Objective: To examine the issue of children and adolescents' entitlement to a dignified death, including the criteria for exclusion, and to formulate a comprehensive plan for pediatric palliative care. A public policy document will be created with the aim of supporting the implementation of Resolution 825/2018.

Methods: Participatory Action Research utilizing a Deliberative dialogue methods that has been adapted based on feminist epistemological principles.

Results: The outcome of the exercise was the production of a document containing Public Policy recommendations regarding euthanasia in minors and its submission to the Ministry of Health and Social Protection of Colombia a few days prior to the release of the Resolution regulating the right to a dignified death for this population. Additionally, the conclusions of this event enabled the creation of a guide for the implementation of (Cabildos Ciudadanos) Citizen Council, in which girls, boys, and adolescents are included, trans-disciplinarity is encouraged, and feminist epistemological foundations are explored.

Conclusions: The deliberative dialogue method may serve as a cost-efficient alternative to replace or complement participatory approaches utilized in the development of public health guidelines and policies.

Keywords: Euthanasia; child health; consensus conference; democracy; feminism; palliative care; right to die; social participation.

Figure 1. Composition of the work panels

Figure 2. Depicts the timeline of the legal evolution of euthanasia in Colombia between the years 1998 and 2018. The following acronyms are used in the figure: C239-1997: Constitutional Judgment C-239/97 issued by the Constitutional Court in 1997 and presided over by rapporteur magistrate Carlos Gaviria Díaz, marking the beginning of the legal debate on mercy killing in Colombia. ST 970/2014: Guardianship Ruling T-970/14 issued by the Constitutional Court, presided over by rapporteur magistrate Luis Ernesto Vargas Silva, regarding the right to dignified death for individuals with terminal illness. ST 423/2017: Guardianship Judgment T-423/17 issued by the Constitutional Court, presided over by rapporteur magistrate Iván Humberto Escrucería, on the fundamental right to die with dignity. ST 322/2017: Guardianship Judgment T-322/17 issued by the Constitutional Court, presided over by rapporteur magistrate Aquiles Arrieta, on the right to a dignified life for the elderly beyond dignified death. ST 721/2017: Guardianship Judgment T-721/17 issued by the Constitutional Court, presided over by substantiating magistrate Antonio José Lizarazo, against the right to die with dignity for individuals in a vegetative state. ST 544/2017: Guardianship Judgment T-544/17 issued by the Constitutional Court, presided over by rapporteur magistrate Gloria Ortiz, on dignified death and the provision of adequate health services for minors. PM: Rapporteur Magistrate. Source: Own creation.

Figure 3. Times contemplated in Resolution 825 of 2018 for the request, analysis and performance of euthanasia in case of a positive concept.

Figura 1. Conformación de los paneles de trabajo.

Figura 2. Línea del tiempo con la evolución jurídica sobre la eutanasia en Colombia entre los años 1998 y 2018. Siglas: C239-1997: sentencia constitucional C-239/97 de la Corte Constitucional sobre el homicidio por piedad presentada por el magistrado ponente Carlos Gaviria Díaz en 1997 como el inicio del debate jurídico en Colombia. ST 970/2014: sentencia de tutela T-970/14 de la Corte Constitucional bajo el magistrado ponente Luis Ernesto Vargas Silva sobre muerte digna en persona con enfermedad terminal. ST 423/2017: sentencia de tutela T-423/17 de la Corte Constitucional acerca del derecho fundamental a morir dignamente a cargo del magistrado ponente Iván Humberto Escrucería. ST 322/2017: sentencia de tutela T-322/17 de la Corte Constitucional sobre el derecho a la vida digna de los adultos mayores más allá de la muerte digna a cargo del magistrado ponente Aquiles Arrieta. ST 721/2017: sentencia de tutela T-721/17 frente al derecho a morir dignamente en persona en estado vegetativo del magistrado sustanciador Antonio José Lizarazo. ST 544/2017: sentencia de tutela T-544/17 sobre muerte digna y adecuada prestación de servicios de salud en un joven menor de edad a cargo de la magistrada ponente Gloria Ortiz. MP: magistrada ponente. NNA: niñas, niños y adolescentes. Fuente: Creación propia.

Figura 3. Tiempos contemplados en la Resolución 825 de 2018 para la solicitud, el análisis y la realización de la eutanasia en caso de ser positivo el concepto. Siglas. NNA: niña, niño o adolescente. Fuente: creación propia.