Dignified death and euthanasia: A difference that matters

In recent days, following the new Public Health Law in Cuba which recognizes the right to a dignified death and sets the conditions for regulating euthanasia, an intense debate laden with emotions has emerged. This discussion is not only taking place in the media but also across social media platforms, where I have witnessed many people, drawing from real experiences of pain, mixing two concepts that are not the same: dying with dignity and causing death. This is precisely why I feel the need to pause for a moment and try to clarify this difference, as it is not just a technical detail: it is at the heart of what we are discussing.

In Cuba, discussing dignified death and euthanasia today is not a theoretical debate. It is an issue that affects thousands of families who have witnessed a loved one die amid pain, hardship, and loneliness. That is why it is so important not to confuse concepts that, while seemingly similar, mean very different things.

DIGNIFIED DEATH is not an action that causes death. It is a way of caring when healing is no longer possible. It means that when a person has an advanced, irreversible, or terminal illness, the focus of medicine changes: it stops fighting the inevitable and concentrates on alleviating suffering. It involves managing pain, calming anxiety, withdrawing treatments that are no longer beneficial, and providing support until the end.

A simple example: a person with advanced cancer is in intensive care connected to a ventilator, unconscious and with no real possibility of recovery. Keeping them on machines indefinitely does not bring them back to life; it merely prolongs the agony. Deciding to withdraw that support and allow them to die peacefully, with sedation and companionship, is a dignified death. It is the illness that prevails, not the doctor.

EUTHANASIA, on the other hand, is something else. Here, the disease is not allowed to take its course: a substance is administered to directly induce death. The intention is no longer merely to alleviate suffering, but to end life in response to pain.

That difference is fundamental: allowing to die is not the same as causing to die.

In healthcare systems where solid palliative care exists, this distinction can be discussed more calmly. However, in Cuba, suffering often arises not only from the illness itself but also from the lack of medications, pain relief, personnel, and basic conditions. And that changes the ethical context.

Let's imagine two people with the same terminal illness. One receives morphine, support, care, and companionship. The other experiences uncontrolled pain, fear, and abandonment. If both say "I want to die," are they expressing the same thing? From a biological standpoint, yes. From an ethical perspective, not necessarily.

When someone asks to die because there is no relief, no care, and no dignity, the question changes: are they choosing death, or are they trying to escape from an undignified way of living out their final days?

Therefore, it is extremely important not to confuse euthanasia with dignified death. DIGNIFIED DEATH requires that the system provides care first. EUTHANASIA, if offered without that, runs the risk of becoming a response to abandonment.

A truly humane society is not measured by how quickly it can provide a way to die, but by how much it strives to ensure that no one has to ask for death because they can no longer endure.

And that difference, today in Cuba, is not a minor detail. It is at the heart of the debate.