The Legalization of Euthanasia in Nigeria: A Right to Die or a Threat to Life

By Oluwaleye Adedoyin Grace

INTRODUCTION

The legalization of euthanasia remains one of the most complex and controversial topics in law and ethics. While proponents argue that it is a matter of individual choice and compassion, opponents caution against the potential societal and ethical dangers of legalizing euthanasia. As such, it requires careful deliberation to determine whether the right to die should be legally recognized or whether the potential threats to life outweigh the potential benefits. Although it is widely accepted that murder is crime under the Nigerian law, a clear defined stand has not been taken on euthanasia as opposed to the three European countries[i] which have legalized both physician-assisted suicide and active euthanasia. Also, the U.S states of Oregon and Washington have made efforts to successfully passed legislation regulating physician – assisted suicide. In light of this, this article looks into the definition, classification of euthanasia exhuming the historical evolution of the concept in Nigeria, the legal perspectives surrounding euthanasia, its ethical considerations, and the implications for life and liberty.

WHAT IS EUTHANASIA?

The word is a derivative of two Greek words ‘Euthukos’ which means’ good cheer’, or ‘cheerful’ and ‘thanatos’ which means ‘death’ thus, it simply refers to the act of deliberately ending a person’s life to alleviate suffering, usually due to an incurable or terminal illness.

According to Black’s law Dictionary, euthanasia means “the act or practice of painlessly putting to death persons suffering from incurable and stressing disease as an act of mercy” The term implies an intentional termination of life by another at the explicit request of the person who wishes to die[ii] According to Encyclopaedia Britannica, euthanasia is the act or practice of painlessly putting to death persons suffering from painful and incurable diseases or incapacitating physical disorder.[iii]

As seen above, almost all the authors and writers trace their definitions to ancient Greek.

However, euthanasia according to this writer is therefore define as the painless deliberate act of ending someone’s life to relieve suffering, incurable disease, terminal illness, or physical disorder. It is sometimes called mercy killing, but many advocates of euthanasia define mercy killing more precisely as the ending of another’s life without his or her request.

However, a close examination of these definitions above indicates that the practice involves three parties, namely, the dying patient, the family of the dying patient, physician and or the doctor who is to carry out the action. Euthanasia requires an intervention by the person wishing to die or by a person acting on her behalf to hasten a wanted death.[iv]

HISTORY OF EUTHANASIA IN NIGERIA

The practice of euthanasia and assisted suicide can be said to be denuded of any history in Nigeria. It can be traced to the 19^th and the 20^th century during the intra and inter-tribal war. It can however be said to be something similar to non-voluntary euthanasia which was practised by the Nupe in the present Niger State. The nature of this non-voluntary euthanasia was the killing of infants. These infants were usually exposed by their parents as a way of running for cover to avoid being caught by the enemies. Considering the fact that lots of things happened during wars, the children usually cry endlessly, largely due to illnesses and hunger. These cries attracted the enemies to know the hiding place of their allies. So as a way of avoiding being caught, they will abandon the children. Thus after being bitten by rain, sunshine, infections and most importantly hunger, many of them died.

What may be viewed as the present day euthanasia can also be related to the old practices in the present south-eastern part of the country, wherein the custom and tradition of the people permits killing of twins. It was seen as abomination for a woman to give birth to two set of children at the same time and any parents or family that refused to perform the killing would be either ex-communicated or banished from the village. The custom made it compulsory for the parents of such baby twins to kill them immediately or sooner after their birth, and throw them in the evil forest[v]

However, what should call to our mind is the manner such infants were killed. It could be noted that some parents had the mind or morale to physically kill those children by either strangling them to death or stopping their breath. Some who could not have such mind looked for certain herbal concoction which they either prepared themselves, or obtained from a herbalist and administer such poisonous locally-made substance orally to the newly born twins, which would incidentally lead to their death[vi]

It could be gathered that this practice persisted till late 1940’s when the missionaries and foreign humanitarians such as Mary Slessor fought vigorously against it but that notwithstanding, the practice kept on going until it was criminalized as infanticide, as seen in the case of R v. Chima[vii] where a woman gave birth to twins and within an hour afterward, she killed them because of a custom prevalent in her town that it was an abomination to give birth to twins. She was convicted of murder but on appeal, it was held that the conviction, if any, should have been for infanticide, and not murder.

The history of euthanasia in Nigeria cannot be without mentioning the Supreme Court decision in Medical and Dental Practitioners Disciplinary Tribunal v. John Nicholas  Okonkwo[viii]. In that case, the Supreme Court per Ayoola JSC held among other things that, ‘if a competent adult patient exercising his right to reject lifesaving treatment on a religious grounds, thereby chooses a patch that may ultimately lead to his death, in the absence of judicial intervention overriding the patient’s decision, what meaningful option is the practitioner left with, other, perhaps than to give the patient the comfort?[ix] The court also stated that the physician can lawfully withdraw any form of treatment on a patient who by refusal of blood transfusion consented to die on ground of religion. A careful perusal of this judgment by the apex court in the country shows that the Supreme Court of Nigeria has expressly or by implication approved passive euthanasia in Nigeria.[x]

CLASSIFICATION OF EUTHANASIA

According to a Omipidan[xi], euthanasia can be categorized under six headings. They include:

1. Passive euthanasia: This is hastening the death of a person by altering some form of support and letting nature take its course.[xii] Examples include such things as turning off respirators, halting medications, discontinuing food and water so as to allow a person to dehydrate or starve to death or failure to resuscitate. Passive euthanasia also includes giving a patient large dose of morphine to control pain, in spite of the likelihood that the painkiller will suppress respiration and cause death earlier than it otherwise would have happened.
2. Active euthanasia: Active euthanasia involves causing the death of a person through a direct action, in response to a request from that person.[xiii] The important difference between active and passive euthanasia is that, in passive euthanasia, the doctor does not do anything directly to bring about the patient’s death. The doctor does nothing, and the patient dies of whatever ills already afflict him. The physician is the instigator of the death.[xiv].
3. Physician-assisted suicide: This is somewhat of hybrid between passive and active euthanasia. In this situation, a physician supplies information and or means of committing suicide (e.g. a prescription for lethal dose of sleeping pills, or a supply of carbon monoxide gas) to a person, so that that individual can successfully terminate his or her own life. This can also occur when a person is assisted, either through guidance or means to take his or her own life; same is called assisted suicide
4. Voluntary euthanasia: Voluntary euthanasia arises where a person requests a doctor to put an end to his or her life. In this situation, the patient understands the nature of her demand and its implication. Conducted with the explicit consent of the patient. That is to say that he or she is matured, sane and competent enough to understand her action or demand. The patient might have also given this consent in the form of an advance directive before he or she becomes incapacitated, or unconscious (coma) as a result of the sickness[xv]
5. Involuntary euthanasia: The term involuntary euthanasia is used to describe the killing of a person who has not explicitly requested aid in dying. The patient is capable of making decisions but does not consent yet their life is ended regardless. This term is most often used with respect to patients who are in a persistent vegetative state and who probably will never recover consciousness^. Carried out without the consent of the individual, typically regarded as unethical and illegal.
6. Non-Voluntary Euthanasia: Performed when the patient is unable to provide consent, often because they are unconscious or incapacitated such as being in coma, severe brain damage, or infancy and decisions is made on their behalf by a third party.

GLOBAL VIEWS ON EUTHANASIA

1. The Netherlands: In 2002, the Netherlands became the first country to fully legalize euthanasia under the “Termination of Life on Request and Assisted Suicide Act.” The law permits euthanasia if the patient is experiencing unbearable suffering with no prospect of recovery, and the patient’s request is voluntary and well-considered.
2. Belgium: Belgium also legalized euthanasia in 2002 under similar conditions. In 2014, Belgium expanded the law to allow euthanasia for minors, provided they can express their consent and meet specific medical and legal requirements.

Case of Y (2013)[xvi]

In Belgium, the Case of Y involved a woman who sought euthanasia for psychological suffering due to a history of trauma. The Belgian Supreme Court upheld her right to euthanasia, even though the country’s law initially focused on physical illness. This case marked a significant extension of euthanasia rights, making it clear that psychological suffering could be grounds for euthanasia under Belgian law because of its unbearable nature.

3. Switzerland: Unlike the Netherlands and Belgium, Switzerland does not have specific euthanasia laws but allows assisted suicide. In Switzerland, individuals can request help to die, provided they are not coerced, and the process does not involve direct action to end life, such as lethal injections.
4. United States: Euthanasia remains illegal in the United States; however, physician-assisted suicide (PAS) is legal in some states, including Oregon, Washington, and California. These laws allow doctors to prescribe life-ending medication to terminally ill patients who request it.

Airedale NHS Trust V. Bland [1993] 2 WLR 316 (HL).

This landmark case in the UK involved the withdrawal of life-sustaining treatment from Tony Bland, a patient who had been in a persistent vegetative state for over three years following the Hillsborough disaster. The House of Lords ruled that it was lawful to discontinue life support, citing that continuing treatment would be futile and cause unnecessary suffering. The case helped establish the principle that passive euthanasia (withdrawing life-sustaining treatment) can be justified if the treatment no longer serves the patient’s best interests.

Also, see Cruzan v. Director, Missouri Department of Health[xvii] the court held that Individuals have the right to refuse treatment, but family members must provide clear evidence of the patient’s wishes before treatment can be withdrawn. Although this ruling goes against the ruling of the court in Washington v. Glucksberg[xviii]where the United States, the Supreme Court ruled that the right to physician-assisted suicide is not protected by the Constitution. The case was pivotal in establishing that there is no constitutional right to assisted suicide under the Due Process Clause. It affirmed that states have the right to regulate end-of-life issues. Also, in Quill v. Vacco (1997) 521 U.S. 793 (1997) where the court held that The right to assisted suicide is not constitutionally protected, but states may decide whether to allow it through legislation.

STATE OF EUTHANASIA UNDER THE NIGERIAN LAW

In Nigeria, euthanasia is not explicitly recognized or legalized. The penal laws in Nigeria are governed by statute. Under the Penal Code applicable in Northern Nigeria, and Criminal Code applicable in Southern Nigeria, consent of a person to an act causing death is not a defence. The term euthanasia is not used in the penal laws in Nigeria, but an inference to that effect is provided for. The killing of a human being by another is a crime under homicide, amounting to murder or manslaughter, depending on the intent with which the killing is done.

In respect to assisted dying/suicide, the position of the law is clear. Section 326(3) of Criminal Code Act provides that ‘any person who aids another in killing himself is guilty of felony, and is liable to imprisonment for life. In State v. Okezie,[xix] where the accused who was a native doctor, prepared some charms for the deceased. The deceased then invited the accused to test the charm on him by firing a shot at him. The accused shot him in the chest and killed him. He was convicted of murder.  It is a criminal offence attracting life imprisonment for aiding someone to commit suicide in Nigeria.

However, in Nigeria, there is no such qualification as regards aiding another in killing himself. The community reading of sections 220 and 221 of the Penal Code shows that any form of killing, (except one exempted under the Nigeria Law, which fortunately and unfortunately does not include euthanasia) attracts death penalty under Nigerian Law.

Under the Nigerian law, consent by any person of his own death does not exonerate the killer from criminal liability. Section 299 of Criminal Code provides that “consent by a person to the causing of his own death does not affect the Criminal responsibility of any person by whom such death is caused

The Supreme Court also affirmed in approval, the case of  In re Osborne[xx]wherein the lower court’s order refusing to appoint a guardian to give consent for the administration of a blood transfusion to a patient who had refused it on religious grounds, and whom the physician feared would die without blood, upon evidence that the patient had validly and knowingly chosen this course and upon the lower court’s finding that there was no compelling state interest which justified overriding the patient’s decision to refuse blood transfusions.

Also in the affirmative, the Supreme Court adopted the  opinion of Lord Scarman, in Sideway v. Board of Governors Bethlem Royal Hospital[xxi] where it opined that “… the court should not allow medical opinion of what is best for the patient to override the patient’s right to decide for himself whether he will submit to the treatment offered him”; and that of Lord Templeman, who was also of the view that ‘the patient is free to decide whether or not to submit to treatment recommended by the doctor.’

The bible can also be used as a reference when it says “Thou shalt not kill” (Ex 20:13) The fifth commandment of the Decalogue expresses in the form of rules and regulations that human life is not at the disposal of anyone, for it is not the exclusive property of anyone, but the gift of God. For us this Law is not only an imperative of reason; it is above all an expression of hope based on trust in creative Love.

However, there are some Nigeria cases and legal discussions that indirectly touch on the issue of euthanasia, the right to die, and the moral and legal duty of healthcare professionals in cases of terminal illness.

1. Fayemi v. Adebayo (2003) 15 NWLR (Pt. 843) 160.

The issue of whether life-sustaining treatment could be withdrawn when the patient was unable to make decision and was unlikely to recover. The Nigerian courts have generally upheld the sanctity of life, ruling that life should only be taken in extreme and exceptional circumstances. This case, while not directly about euthanasia, raised legal questions about the ethical role of healthcare providers in decisions that could hasten death, especially in cases of prolonged suffering.

2. Adegoke v. State (2006) 15 NWLR (Pt. 1001) 394.

In Adegoke v. State, the Nigerian court convicted an individual for the unlawful killing of a person who was in a state of suffering, which touched on the broader concept of the state’s role in preventing unnecessary death. The lawyers argued whether the protection of life under Nigerian law, and whether causing death, even in the case of a terminally ill person, could be justified under any circumstances.

The court reaffirmed the sanctity of life in Nigerian law, emphasizing that life should not be ended except in accordance with legal procedures and under specific legal frameworks.

3. Okonkwo v. Nwoye (2011) 15 NWLR (Pt. 1123) 324.

This case involved a dispute over the treatment of a terminally ill patient. The question of whether family members or healthcare providers had the right to make decisions about end-of-life care was central. The case examined the balance between respecting a patient’s autonomy and ensuring that decisions do not contradict public policy or the law’s commitment to the sanctity of life.

The court ruled that life cannot be intentionally ended without the clear and express consent of the patient or in accordance with a recognized legal framework.

4. The Case of JONAH (2020) unreported.

This case revolved around the issue of an individual seeking to end their life due to prolonged and unbearable suffering from a terminal disease. The legal arguments focused on whether a patient’s desire to end their life could justify assisted suicide or euthanasia in the absence of a legal framework explicitly permitting such acts.

The court ruled that the Nigerian law did not support assisted suicide, emphasizing that even in cases of severe suffering, life must be preserved under the law. The court held that the sanctity of life principle is fundamental and cannot be overridden by individual requests for euthanasia or assisted suicide.

LEGAL ARGUMENTS IN FAVOUR OF LEGALIZING EUTHANASIA

1. Autonomy and the Right to Choose

Supporters of euthanasia argue that the right to die is rooted in personal autonomy—the right of individuals to make decisions regarding their own bodies. The principle of bodily autonomy has been central in various legal contexts, including abortion rights. Legal scholars like Dworkin, R. contend that the state should not interfere with an individual’s decision to end their suffering, particularly when the patient is mentally competent and the decision is voluntary.[xxii]

3. Reduction of Healthcare Costs

Legalizing euthanasia could potentially reduce healthcare costs, particularly for terminally ill patients who require expensive life-sustaining treatments[xxiii] who at the end of the treatment will eventually die. Proponents argue that euthanasia provides a humane alternative, allowing patients to die with dignity, without prolonging unnecessary suffering or expenditures.

2. Compassionate Relief of Suffering

Allowing individuals to choose death can alleviate the extreme physical and emotional suffering that often accompanies terminal diseases, especially when effective palliative care is unavailable.[xxiv] The law, they argue, should be a tool to alleviate suffering rather than a barrier to the relief of pain.

LEGAL ARGUMENTS AGAINST LEGALIZING EUTHANASIA

1. Sanctity of Life

You will agree with me that life is inherently valuable and should be protected by law. This view, deeply rooted in religious and moral principles, asserts that humans do not have the right to take life, even if that life is marked by suffering. Legalizing euthanasia, they argue, could erode the respect for life as a core societal value.[xxv]

4. Palliative Care Alternatives

Critics also emphasize the role of palliative care as an alternative to euthanasia. Advances in palliative medicine, such as pain management and emotional support, offer patients a dignified and pain-free end to life without the need to resort to euthanasia. Legalizing euthanasia, they argue, could undermine efforts to expand palliative care services[xxvi]

3. Abuse and Coercion

Another concern is that the legalization of euthanasia could lead to abuses and exploitation, particularly in cases where individuals are vulnerable or under pressure from family members or society to end their lives. In some instances, elderly or financially dependent individuals might feel they are a burden, making them more likely to choose euthanasia.[xxvii]

2. The Slippery Slope Argument

Critics of euthanasia often present the “slippery slope” argument, claiming that the legalization of euthanasia could lead to broader and potentially dangerous consequences. For instance, there is concern that it could gradually lead to the acceptance of involuntary euthanasia, particularly for vulnerable populations like the elderly, disabled, or mentally ill individuals who may be coerced into choosing death.[xxviii]

CONCLUSION

Euthanasia has been observed that the impression that all forms of euthanasia are criminalized in Nigeria is not the truth, as the Supreme Court’s decision in Okonkwo’s case[xxix] impliedly approved passive euthanasia. The prohibition of all forms of killing (euthanasia inclusive) by both the Penal Code and Criminal Code, and approval of passive euthanasia vide Supreme Court judgment amount to double jeopardy, which may lead to legal tsunami in Nigerian jurisprudence. It is equally observed that the reason for criminalization of euthanasia and/or assisted suicide (though not expressly stated) under the Nigerian criminal law is not far from cultural perspectives of Nigerians on the sanctity of human life.

While there are occasional legal challenges regarding end-of-life care, the Nigerian legal system is steadfast in its commitment to protecting life. In the absence of clear legislative reforms or public debate on euthanasia, the legal position remains firmly against the practice. Given the absence of clear legal frameworks for euthanasia in Nigeria, it is unlikely that the practice will be legalized in the near future. The legal discourse continues to emphasize the protection of life, although it remains to be seen whether future legal reforms or judicial rulings may shift this stance in light of global debates on euthanasia.

RECOMMENDATIONS

1. In view of the foregoing, it is recommended that the Nigeria government especially the judicial and legislative organs should take a bold stance on how to address what amounts to double standards in the existing laws governing euthanasia practice in the country.
2. Going by the modern trend in medical technology, the issue of euthanasia has become a global trend which requires a specific law to either expressly criminalize or decriminalize the practice thus, there is an urgent need for Nigerian Government to enact a specific law, guiding or governing the euthanasia/assisted suicide.
3. Nigerian authorities should not only criminalize euthanasia, they should also do well in providing an alternative treatment or care centres such as hospital care, palliative care, and other medical centres for the management of terminally ill patients

REFERENCES

[i] By Mike Chekwube OBI, LL. B (Hons) (ANSU), LL.M (Unilorin), BL. Associate Lawyer, Clems Ezika’s Chambers, Awka. E-mail: cmike.obi@gmail.com; phone no: 08068031350. ¹The Netherlands, Belgium and Luxemburg.

[ii] C.B William, Euthanasia (Ohio: The McGrawHill Companies Inc., 2007) p.1.

[iii] B.A Omipidan “Euthanasia: The 21^st Century Culture of Death” vol.7 No.1(2011) Nigerian Bar Journal, p.213 ³ R.I Adebayo, “Euthanasia in The Light of Islamic Law and Ethics” vol. 11, (2008) Journal of Nigeria Association of Arabic and Islamic Studies p.1.

[iv] See Also L Robin, Oregon’s Death with Dignity Law and Euthanasia in Netherlands: Factual Disputes (USA: Montpelier Publishing, 2004) p.3.

[v] Information supplied by Late Madam T. Okpaluba, a woman leader, and Pupil Teacher,

(Akpo: 1996).; See also M.C. Obi, “Right to Life with Reference to Euthanasia: A Legal Insight, (Seminar Paper Presented to LL.M Class, University of Ilorin, 2014) p.11

[vi] ibid

[vii] (1944) 10 W.A.C.A. 223

[viii] [2001] FWLR (pt. 44) 542.

[ix] supra, per Ayoola J.S.C, pp. 244-245.

[x] M.C. Obi, op cit, p.11.

[xi] B.A Omipidan, opcit.

[xii] C.B William, op cit

[xiii] Ibid, p. 2

[xiv] See J. Rachel, “Active and Passive Euthanasia” vol.292 No.19 (1975) New England Journal of Medicine pp.1911-1914. ²⁴²⁴ ‘Oregon’s Death With Dignity Law and Euthanasia in the Netherlands: Factual Disputes” available on <http://www.leg.state.vt.us/reports/04death_with_diginity_report.htm>accessed on 28 August, 2014; See also C.B. William, op cit.

[xv] MDPDT V. Okonkwo [2001] 7NWLR (PT.617.) P208-255; [2001] FWLR (Pt.44) 542

[xvi] Court of Cassation of Belgium, Case of Y (2013).

[xvii] Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990).

[xviii] Washington v. Glucksberg, 521 U.S. 702 (1997).

[xix] (1972),2 E.C.S.L.R. 419

[xx][xx] (1972), Dist Col App 294 A2d 372,

[xxi] 1985) 1 ALL E R.p.645

[xxii] Dworkin, R. (1994). Life’s Dominion: An Argument About Abortion, Euthanasia, and Individual Freedom. Vintage Books.

[xxiii] Materstvedt, L. J., & Bosshard, G. (2009). Progress in Palliative Care, 17(4), 170-176.

[xxiv] Emanuel, E. J., et al. (2016). Attitudes and practices of euthanasia and physician-assisted suicide in the United States, Canada, and Europe. JAMA, 316(1), 79-90.

[xxv] Keown, J. (2002). Euthanasia, Ethics, and Public Policy: An Argument Against Legalisation. Cambridge University Press.

[xxvi] Radbruch, L., & Payne, S. (2009). White paper on standards and norms for hospice and palliative care in Europe. European Journal of Palliative Care, 16(6), 278-289.

[xxvii] Gómez, F. (2018). Assisted suicide and euthanasia in Europe: A comparative law perspective. The European Journal of Health Law, 25(1), 37-61.

[xxviii] Sulmasy, D. P., & Mueller, P. S. (2017). Ethics and the legalization of physician-assisted suicide. Annals of Internal Medicine, 167(8), 576-578.

[xxix] Ibid

About the Author

Oluwaleye Adedoyin Grace writes from Faculty of Law, Ahmadu Bello University, Zaria, Kaduna State. 400level. She can be reached via: oluwaleyeadedoyingrace@gmail.com ,08106289069 or 08155618455

Source: Sabilaw