On May 7, the Supreme Court of Estonia ruled that assisted suicide is a fundamental right for any competent person wishing to end a life voluntarily for any reason and that assisting someone in that act is not a healthcare service.
The ruling comes in response to a criminal case against Paul Tammert that was sent to the court by the South District Prosecutor’s Office on October 11, 2023. Tammert had created a homemade suicide device that included a gas cylinder connected by tubes to a mask. Tammert rented the fully operational device to users, and users were responsible for initiating the suicide process. The device was used at least three times, with two people dying and one person surviving due to the device running out of gas.
As ERR News reported, county and circuit courts found Tammert guilty of “conducting unlicensed economic activity in a field related to healthcare services”; the Supreme Court, somewhat confusingly, ruled that because suicide is not health care, Tammert could not be guilty of conducting economic activity without a license and acquitted him. Tammert, the court noted, had not been involved in diagnoses, examinations, or treatments, and he had not personally facilitated their suicides.
But the court ruled further that voluntary suicide is a fundamental right, that assisting someone’s suicide is only criminal if that person “cannot act independently or lacks full understanding of their actions,” and called on Estonian parliament to “create regulations for nonmedical suicide facilitation to prevent abuses, citing the need for a clear legal framework as supported by the European Court of Human Rights.” According to the ruling:
The concern voiced by the prosecutor during the hearing is understandable – that if assistance in ending life becomes offered as a service, clear principles will be necessary, considering the extent of intervention in a person’s health and the need to prevent potential abuses. This would include establishing when such assistance may be provided, by whom, on what basis the necessity of the service would be determined and how the procedure would be carried out. The lack of clear principles could lead to undesirable consequences and expose the state to liability.
The court noted further that “If the state allows easy access to assisted dying services, it is particularly important to establish the necessary legal framework to prevent potential abuses in the provision of such services.” At time of writing, the Estonian government has not yet responded to the ruling or affirmed its intent to begin work on assisted-suicide legislation, and public opinion on the issue remains sharply divided.
As ERR News noted, the Estonian Supreme Court ruling appears to be following a European trend. “Five years ago, the highest court in Germany declared that committing suicide is a fundamental right – for everybody and for any reason – and that being assisted or assisting others in the act are ancillary rights associated with that liberty,” ethicist Wesley J. Smith wrote in National Review. “In other words, death on demand. Now the Supreme Court of Estonia appears to have followed the same course.”
Assisted suicide is a legal right in at least some circumstances in Switzerland (since 1942), Germany (2020), Austria (2022), Belgium (2002), the Netherlands (2001), Luxembourg (2009), Spain (2021), Italy (2019), and Portugal (2023, although it has not yet come into effect). Assisted suicide and euthanasia remain illegal in 41 European countries. The United Kingdom is currently debating the legalization of assisted suicide, with recent reports indicating that a majority of MPs may be poised to vote against it later this month.
