FEMINIST PULSE
Assisted Suicide and the Limits of Choice
With the approval of Noelia Castillo Ramos’s request to end her own life, the Spanish government is moving into a dangerous territory: deciding how to handle lives broken by violence. As opposed to fixing the system, the state is legally sanctioning death as a solution for suffering.
Classifying post traumatic mental suffering as a “chronic and incurable” condition, the legal framework has established a new gamut of women it is failing to protect. We are witnessing a newly emerging pattern where victims of sexual abuse, people with disability, the elderly – the most vulnerable in our society- ., are offered “dignified” exit as a substitute for necessary support they must receive.
There is no “mercy” in facilitating the death of a victim of gang rape – an act of sexual violence that triggered Castillo’s decision for euthanasia, following her suicide attempt that made her paraplegic This is the authorities’ disowning all of its responsibility to end male violence that contributed to it. Rather than prosecuting the perpetrators, by sanctioning the elimination of the victim, the state has walked away without any atonement. Given the context, euthanasia becomes a form of social cleansing – a way to eradicate those who undergo ongoing suffering who act as a reminder of the state’s incompetence.
In the context of the current discussions on “agency”, “consent” and “choice”, Castillo’s story raises a deeply unsettling question: When a woman opts death following sexual violence, how must this “agency” be understood? The conditions that led her to this decision can’t be isolated from her lifelong trauma and violence, the absence of justice, and all the other structures that failed her. It makes us confront how such laws could be the final response to a society that failed to protect women and girls.
Regulating Euthanasia in the Context of Violence against Women in Spain
Spain legalised euthanasia through Organic Law 3/2021 allowing assisted suicide for adults with “serious, chronic, or incurable diseases causing intolerable, permanent suffering”. It allows for voluntary Medical Assistance in Dying (MAiD), providing a legal framework to ensure the process is safe, voluntary, and dignified. Since its passing, the law has been used in cases of severe illness or irreversible decline.
Castillo’s case sat within this framework, shaped though it was by violence, rather than disease. Her request was not approved initially. The law requires that it be reviewed by multiple medical professionals and a regional oversight commission (Catalan Commission for Guarantees and Evaluation) to check if all criteria are met.
Several medical authorities were consulted and they upheld that her decision met the legal requirement of it being a “free, conscious and informed decision”.
Spain prides itself on being a “feminist state”. With strong laws on violence against women and “feminist foreign policy”, Spain is widely considered as one of the most progressive states in the domain of women’s rights. However, male violence against women remains a persistent and systemic issue in Spain. The Spanish Ministry of Equality reports thousands of sexual assault complaints each year, apart from ongoing cases.
Rape is a known significant factor that can lead to suicide: Women who have been raped are thirteen times more likely to try and take their own life. Rape victims are also ten times more likely to develop drug addiction. There is also a chilling silencing effect among young women in Spain where a research on university campuses concluded that 24% of women who were abused, did not tell anyone. They attribute this silence to a complete lack of faith in the judicial system’s ability to protect them without worsening their trauma (institutional betrayal). In her final broadcast interview, Castillo confirmed that she did not report her assaults to the authorities. While it is right to wonder why, it is important to understand the context of a young girl being in state care riddled with negligence. The question must be directed to the system that allows such crimes to happen.
Autonomy, Reality and State Responsibility
In the Relational Autonomy, the authors Mackenzie & Stoljar discuss how autonomy is never just an individual choice, but is “socially embedded”. In their paper Feminist Perspectives on Self, Agency, and the Social Self, they say, if a woman’s social environment – the state, the law – is oppressive in nature, or fails to provide a pathway to healing, her alleged “autonomous” choices are limited to the few options she may have: including the right to exit.
Our approach to euthanasia must not just be limited to pondering whether it is right or wrong. It is crucial to look at conditions that make death seem like a relief. When a young woman’s agonising pain forces her to plead for death, who owns that pain? Who bears the costs? And, who profits from “assisted suicide” acts? Financially, it is a significantly cheaper option for the state when compared to providing specialised mental health services, disability and elderly care, and a functional judicial system that delivers justice.
Feminism always advocates for women to have agency to define the realities of our lives. And in this reality, there must exist a genuine possibility of a livable life. It can’t be attributed to ‘agency’ when it is the euphemism the state wants to hide behind due to its callous attitude towards male violence.
True agency requires informed autonomy. Having access to resources for healing, support from a community, and above all, non-discrimination on the basis of sex, justice, and protection of the law, is what forms the circumstances within which an informed autonomy can be experienced and enacted. Without those conditions, the “choices” that women make will inevitably include those that inflict self-harm
Our responsibility as a society is not to advocate for the “right” of a 25 year old survivor of violence to die, but to demand a world that centres her life as a non-negotiable.
For a state that claims to be “feminist” to support women’s agency, it needs to transform the circumstances that lead to such tragedies. At the very least, it must ensure that women are not left choosing between a life of state-sanctioned neglect and the potential finality of a state-sanctioned death.