Prawo do umierania w spokoju i godności jako instrument ochrony prawnej pacjenta przed praktykami charakterystycznymi dla systemów totalitarnych i autorytarnych
The Right to Die in Peace and Dignity as an Instrument of Legal Protection of the Patient against Practices Characteristic of Totalitarian and Authoritarian Systems

Summary/Abstract: The article is devoted to the problem of the collision of legal norms regulating the patient’s rights: to die in peace and dignity, to consent to the provision of health services, and to receive pain relief. The analysis is specifically focused on the provisions of the Act on Patient Rights and the Ombudsman for Patients’ Rights, and supplementary on the relevant sets of deontological standards. Considerations regarding to contemporary legislation are preceded by historical remarks relating to the patient’s situation in totalitarian and authoritarian systems, based on the examples of the Third Reich and the Polish People’s Republic. The study assumes that current Polish civil law provide special legal protection for the autonomy of a person close to death—unlike previous legal systems. The results of the linguistic and systemic interpretation as well as conflict of laws directives led to the formulation of the thesis that the right to die in peace and dignity, the right to pain relief and the right to the presence of a close person when providing health services are elements of the patient’s right to respect for his dignity and intimacy. It was inferred from this that the treatment of pain in the terminal phase of the disease is governed by specific rules as regards the patient’s ability to give binding consent or objection to medical measures. This conclusion was also supported by arguments of a functional nature. Taking it into account also led to the conclusion that legal treatment of pain in a dying patient requires his consent, provided that he has sufficient discernment (regardless of age and possible incapacitation). The same reasons allowed for the recognition that declarations of will made by a dying patient for the future regarding the method of treating his pain have legal force. Detailed considerations led to the conclusion that what remains to be discussed is not the direction of interpretation according to which the patient in the last period of life has an extended scope of autonomy, but the degree of this extension, because a democratic state ruled by law should not allow the patient to be objectified, even for medical reasons, in a manner reminiscent of the dehumanization of human beings in totalitarian and authoritarian systems.

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