BOGOTA, Colombia — Dr. Gustavo Alfonso Quintana felt helpless as cancer spread through his patient, leaving him disfigured, virtually blind and in excruciating pain. But in Colombia, the only country in Latin America where euthanasia isn't outlawed, there was one thing Quintana could do to end the 23-year-old student's suffering.
"He pleaded to be helped to die, saying, 'I don't want to wait until I've turned into a monster,'" Quintana recalled in a rare interview with The Associated Press. He said the disease had spread through his groin, lungs and brain. His testicles were deformed, a huge lump had developed on his skull, and the area around his eyes was black and swollen and getting worse.
The doctor spent days in anguished discussions with the patient and his family. Then just over a year ago relatives gathered around the patient and held his hand as the bald, bespectacled Quintana injected lethal drugs into his arm.
Quintana would not identify the patient. On the death certificate, he wrote "cardiac arrest," omitting any reference to the injections that put the man to sleep, paralyzed him and then stopped his heart.
In Colombia, euthanasia became permissible in 1997 when the highest judicial body, the Constitutional Court, ruled 6-3 that an individual may choose to end his life and that doctors can't be prosecuted for their role in helping. The decision came in response to a case in which an opponent of euthanasia had sought to strengthen its prohibition.
The court urged Congress to codify the practice to prevent abuses. Lawmakers, apparently reluctant to take on such an emotionally charged debate in this predominantly Roman Catholic country, still haven't done so.
But Carlos Gaviria, the judge who wrote the court's majority ruling, is now a senator, and he plans to submit a bill to Congress to regulate the practice.
"It's important that we establish clear guidelines," he told the AP.
Gaviria said he will submit a bill to the present legislative session establishing guidelines similar to those in the Netherlands and Belgium, where doctors must seek second opinions, give patients rigorous mental tests before inducing death, and have cases reviewed by government commissions.
In Colombia, there are no such restrictions.
"Currently, it's solely up to the patient and his doctor to decide on whether to induce death," said Dr. Juan Mendoza, head of the Right to Die with Dignity, an activist group. "There is no legal obligation even to report it to authorities."
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Since no records are kept, there are no figures on how many doctor-assisted suicides have occurred in Colombia.
The issue has received little public attention in Colombia, but Gaviria's bill is expected to change that. Colombians are evenly split on the subject, with 45 percent in favor of inducing death in terminal cases and 46.9 percent against, according to a Yanhaas poll for RCN radio. The poll, released in March, had a 4 percent margin of error.
The Catholic Church, which tried unsuccessfully to have the court ruling overturned, says it won't stay on the sidelines.
"We will make our opinions heard, through the press or communiques and public appeals," said Monsignor Juan Vicente Cordoba, auxiliary bishop of the northern city of Bucaramanga and a bioethics expert. "We have always urged all Catholics to have nothing to do with euthanasia, as life belongs to God."
In 90 percent Catholic Colombia, the church has strong influence on legislators, but the role of Congress is to draw up rules and regulations to prevent abuses, not to change the core of the court's ruling. To do that it would have to change the constitution itself.
Quintana says he has performed euthanasia on some 15 patients and wants the practice to remain a matter between doctor and patient, without red tape or court battles.
He said he has refused to euthanize patients he believed still had reason to live, including one who asked to die because he was slowly going blind. He said that before he agrees to do it, he always first asks himself this question: "If I were in his position, would I want to end my life?"
"If I find the answer to be yes, then I proceed to induce death," he said. "It's never easy, but I do it out of respect and affection for my patients."
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