DYING

Slovenia’s parliament had approved a law in July, allowing assisted dying after a 2024 referendum supported it.

Slovenians have rejected in a referendum a law that allowed terminally ill adults to end their lives, after critics mounted a campaign against the legislation.

About 53 percent of 1.7 million eligible voters voted against the law that proposed legalising assisted dying, according to preliminary results released by the election authorities on Sunday.

The results mean the law’s implementation will be suspended for at least one year. Slovenia’s parliament had approved the law in July, allowing assisted dying after a 2024 referendum supported it.

But the new vote was called after a civil group, backed by the Catholic Church and the conservative parliamentary opposition, gathered more than the 40,000 signatures required for a repeat.

Ales Primc, head of Voice for the Children and the Family, the NGO that organised the no vote campaign, reacted to the results, saying “solidarity and justice” had won.

“We are witnessing a miracle. The culture of life has defeated the cult of death,” Primc said after the vote.

Under the disputed law, terminally ill patients would have had the right to aid in dying if their suffering was unbearable and all treatment options had been exhausted.

It would also have allowed for assisted dying if treatment offers had no reasonable prospect of recovery or improvement in the patient’s condition, but not to end unbearable suffering from mental illness.

Prime Minister Robert Golob had urged citizens to back the law “so that each of us can decide for ourselves how and with what dignity we will end our lives”.

But the Catholic Church has said allowing assisted dying “contradicts the foundations of the Gospel, natural law and human dignity”.

In June 2024, 55 percent had backed the law.

Turnout at Sunday’s referendum was 40.9 percent – just enough for the no vote to meet the threshold.

Several European countries, including Austria, Belgium, the Netherlands and Switzerland, allow terminally ill people to receive medical help to end their lives. However, it remains a crime in others, even in cases of severe suffering.

In May, France’s lower house of parliament approved a right-to-die bill in a first reading. The British parliament is debating similar legislation.

Slovenia is voting on whether to legalise assisted dying for some terminally ill adults after other European countries have made the change.

The parliament of the small European Union nation passed a euthanasia bill in July, but a citizens initiative, led by right-wing politician Ales Primc, forced the referendum on Sunday.

The law will be rejected if at least 20 percent of participating voters oppose the bill. Slovenia has an electorate of 1.69 million people.

Supporters of the bill said it will alleviate unnecessary pain. Those against said society should care for the sick, not help them die.

Several European countries – including Austria, Belgium, the Netherlands and Switzerland – already allow terminally ill people to receive medical help to end their lives.

What are the Slovenes proposing?

Under the disputed law, which was set to take effect this year, lucid but terminally ill patients would have had the right to die if their suffering had become unbearable and all other treatment options had been exhausted.

The legislation is similar to the assisted dying bill passed by the United Kingdom Parliament in June. Britain’s bill allows assisted suicide for terminally ill adults with less than six months to live, the approvals of two doctors, judicial oversight and self-administration of the medication.

Slovenia’s law would require the approval of two doctors but also cooling-off periods and self-administration of the medication.

About 54 percent of citizens back the legalisation of assisted dying, almost 31 percent oppose it and 15 percent are undecided, according to a poll published this week by the Dnevnik daily based on 700 responses. In June 2024, 55 percent backed the law.

What are supporters saying?

Prime Minister Robert Golob urged citizens to back the law “so that each of us can decide for ourselves how and with what dignity we will end our lives”.

Marijan Janzekovic, an 86-year-old who lives in the town of Sveti Tomaz near the capital, Ljubljana, also supports the bill.

His wife, Alenka Curin-Janzekovic, was in pain from diabetes-related illnesses before she ended her life at a suicide clinic in Switzerland in 2023.

“She was in a wheelchair … and in pain so bad my heart hurt just by watching her,” he told the Reuters news agency.

What do opponents think?

The main political group opposing the law, called Voice for the Children and the Family, has accused the government of using the law to “poison” ill and elderly people.

Opponents said the law is inhumane and violates Slovenia’s Constitution, which declares human life inviolable.

Elsewhere, Slovenian Catholic Archbishop Stanislav Zore said the state should focus on palliative care instead.

“Let’s care for the sick and dying but not offer them suicide,” he said. The Catholic Church is opposed to euthanasia.

What other countries practise assisted dying?

Assisted dying is already permitted in Australia, New Zealand, Canada, several states in the United States, the Netherlands, Belgium, Luxembourg, Austria, Germany, Portugal, Spain and Switzerland.

In Australia, New Zealand, Canada and several US states, assisted dying laws are generally framed around medical aid. These jurisdictions typically require that patients be terminally ill, mentally competent and assessed by two independent doctors.

In many of these countries, the patient must self-administer lethal medication rather than have a doctor provide it directly. These regimes prioritise patient autonomy and strict procedural safeguards, such as waiting periods.

In the Netherlands, Belgium, Luxembourg, Spain and Portugal, the approach to assisted dying is permissive. Active euthanasia or doctor-administered treatment is legal under defined conditions of unbearable suffering, even if the patient is not terminally ill.

In Germany, Austria and Switzerland, only assisted suicide is legally tolerated as opposed to active euthanasia. Switzerland is an outlier insofar as there is no dedicated regulatory regime for euthanasia, meaning nonresidents may access the service via organisations.

Which other countries are currently debating assisted dying laws?

In May, France’s National Assembly approved a “right-to-die” bill. The legislation would allow adults over 18 who are citizens or residents and suffer from incurable illnesses and “intolerable” physical or psychological suffering to request lethal medication.

Under the bill, a medical team must assess the patient’s condition before a mandatory reflection period before the prescription of a lethal substance. If the patient is physically unable to self-administer, a doctor or nurse may assist.

The proposal excludes people with severe psychiatric conditions or neurodegenerative disorders like advanced Alzheimer’s disease. The bill now has to go to the Senate and must return to the National Assembly for a second reading before it could become law.

Elsewhere, Britain’s lower house voted to legalise assisted dying in June. The House of Commons narrowly voted in favour of the Terminally Ill Adults (End of Life) Bill, marking a major step towards legalising assisted dying in England and Wales.

The bill would allow mentally competent adults with a prognosis of less than six months to live to request medical help to end their lives, subject to assessments by two doctors and a panel including a psychiatrist, a lawyer and a social worker.

The legislation is not yet law. It must still get through the House of Lords, where it will be further scrutinised and may be amended. If it does become law, the timeline for implementation may not be until 2029.

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‘Part of my community’

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Kathryn Martin

Kathryn Martin

Maverick’s story

It was a cold November morning, and I had travelled with my family to our ancestral temple in a village in Tamil Nadu. My sister’s 11-month-old baby was to be tonsured for the first time – a religious head-shaving that in Hinduism is a way of discarding the evil eye and removing any negativity from past lives; a new start.

My wife drove, but asked me to park the car while she went inside with our son and her parents. I walked around the front of the vehicle and slid into the passenger seat. But when I tried to park, I felt resistance. As I pressed down on the accelerator, I noticed a middle-aged man running towards me, waving his arms frantically as he yelled for me to move the car backwards.

My mind raced as I reversed. I prayed silently that I hadn’t hurt anyone.

It was only when I got out of the car that I saw her. The thin, frail woman who now lay on the ground, shaking and murmuring. Panicked, my mind tried to make sense of how she’d come to be there – she must have sat down, assuming I’d already parked – and how badly injured she was. She curled into a foetal position as I sat down beside her and gently placed her head on my lap.

“Does it hurt anywhere, paati (granny)?” I asked.

She nodded, pointing to her leg.

I slowly pulled back the torn sari near her knee. The flesh was missing.

“You’ve been hurt, but we’ll take care of it,” I promised.

“No one will take care of me … just let me sit,” she pleaded.

Villagers started to gather, but kept their distance. One man said the woman slept on the streets near the temple and was often seen begging. A woman chided her for always sitting too close to cars. “If you don’t do something now, no one will take care of her, and she’ll die,” a man muttered before leaving.

Between groans, the woman told me her name: Chinnammal.

“Can you find my bag, thangam?” she asked, using a Tamil term for a loved one that translates to “gold”. She was in pain, but speaking to me, the person who had caused it, with such kindness.

I looked around and found her old cotton bag. It was stuffed to the brim with an open packet of chips, a half-eaten bun, a few 10-rupee notes, and some clothes.

The ambulance arrived, but there was only the driver, and it would take at least three people to lift her safely; we needed another pair of hands. There were close to 25 people around us, but no one moved.

“No one will come to lift her. She’s from a different caste. I have come to do temple rituals – otherwise, I would help,” a priest explained before hurrying away.

My wife, who had by now seen the commotion and approached, stepped forward to help, and together, we lifted Chinnammal into the ambulance. I climbed in with her.

I could see from her face that the pain came in waves. I sat next to her, one arm under her shoulders, in a kind of half-hug.

“My bag?” she asked, looking relieved when I placed it beside her hand.

“You are the first person to take me in a car,” she told me, her voice trembling.

She called me saami, a Tamil term that translates to God. I couldn’t understand how she could show me such love and respect. I asked for her forgiveness, but she simply asked me to help her sit up.

When we pulled into the hospital, two nurses in neatly pressed white uniforms appeared with a stretcher. I helped the ambulance driver lift Chinnammal onto it and wheeled her into the hospital. I told the nurses what I knew of her injuries, while they exchanged uneasy glances. When Chinnammal lurched forward and vomited, the nurses scolded her and backed away in disgust.

Inside the emergency room, the nursing manager explained that Chinnammal’s blood pressure and heart rate were high, but she was stable. She had two major injuries – a broken hip and severe grazing that would require skin grafts. Her leg, he said, was not so serious and would heal quickly.

Chinnammal reached for my hands. Hers were small and bony, but her grip was firm. Her eyes flickered, drifting in and out of focus. A soft-spoken doctor told me it was a miracle she was stable after sustaining such serious injuries.

She quietly listened to the doctor speak, but when he mentioned it would take three months for her hip to heal, Chinnammal started to wail.

“I will visit you every weekend, paati,” I reassured her.

The hospital staff took Chinnammal for an electrocardiogram, and when she returned, now hooked up to a heartbeat monitor, she grasped my hands again. She tugged on one. I leaned in. “Ask them to give me medicine to die,” she said.

I assured her that the doctors would take good care of her and that I would be there to make sure of it.

“They won’t,” she replied.

Then she looked into my eyes and lost consciousness.

I grabbed hold of her hand, but it was limp. I fell to the floor, sobbing.

Chinnammal was pronounced dead at 8.30 am on November 20, 2022. She was about 75 years old.

Chinnammal’s story

Chinnammal didn’t always live on the streets. As a younger woman, she was impeccably dressed, with flowers woven into her neatly plaited hair.

She hadn’t always begged for handouts either. She worked hard to farm a piece of land for her family, but her married life was difficult. Her husband was an alcoholic, and Chinnammal had to raise her daughter, run the house, and farm their land with little help.

She doted on her daughter and was happy when she married a man from a nearby village. A few years after her daughter married, Chinnammal’s husband died. Chinnammal adapted easily to life as a widow. She enjoyed visiting her daughter and son-in-law and would take them homemade sweets. When they struggled to conceive, Chinnammal worried, but she was overjoyed when they decided to adopt. She loved watching her grandson grow. He became her “everything”.

That joy was short-lived. Chinnammal’s daughter fell ill with a severe form of diabetes. When Chinnammal wasn’t at her daughter’s bedside, she was at the temple, praying for her, or concocting various treatments from herbs that she hoped would help.

But nothing worked, and Chinnammal watched her daughter slowly die.

That was the moment Chinnammal’s life changed. She stopped interacting with people. Some villagers started to harass and steal from her. She once filed a police complaint against a drunk neighbour who harassed her, but the police refused to help. Late one night, when she caught the man near her home, she threatened him with a sickle.

In her grief, Chinnammal no longer cared where she slept, what she ate, or how she dressed. She started to sleep by the temple, clutching her cloth bag close to her.

After Chinnammal’s death

A few hours after Chinnammal’s death, I went to the local police station and handed myself in.

A police officer contacted Chinnammal’s son-in-law to release her body and begin the family’s settlement case against me.

Her son-in-law initially refused to claim her body. The investigating officer told me he’d said, “She should have died a long time ago. She was just a burden … You can ask them to bury her and move on.”

But the officer insisted, and the man reluctantly came to the station.

When he arrived, I gave Chinnammal’s bag to the police officer, who inventoried its contents and shared the details with her son-in-law. His demeanour changed. He wanted to claim the body and register himself as her closest living relative, he explained.

“There was close to two lakhs ($2,250) in the bag you surrendered, and now this guy is trying to claim it and the compensation that the government might pay,” the police officer told me.

Chinnammal’s death felt like losing a loved one. I knew I had caused it. But she had shown no anger or animosity towards me. In her final hours, she had treated me with kindness and compassion. She had shared her love for her daughter and grandson with me, held my hand, and spoken tenderly to me despite her pain.

At the hospital, a doctor had tried to console me. “What if you had hit a child?” he’d asked. “Could you live with yourself?”

“She had lived her life,” he reasoned. But his reasoning made no sense to me.

The following day, I went to the temple to help the police with their investigation. As I stared at the spot where my life had changed, a priest interrupted my thoughts.

“You did a good job,” he said. Thinking he was chastising me, I apologised.

“No, I mean it,” he responded. “Nobody used to go near her. Local drunks used to steal the money she collected. So she used to cuss and throw stones at anyone who came near her. She had absolutely no one in this world.”

Even the temple staff used to chase her away, he explained.

“I think she chose to go through you. Through you, she died with dignity, the dignity that was denied to her in life,” he said, urging me to be at peace.

But nothing could give me peace.

I stopped driving. For a year, I withdrew from friends and family. I couldn’t sleep and, when I did, I’d see Chinnammal in my dreams. Whenever I was alone, I would think about her, replaying that day in my mind and wondering what might have happened had I done something differently.

Nearly a month after her death, I was able to track down the contact information for Chinnammal’s 19-year-old grandson. I called to ask for his forgiveness, and he asked me about the last moments I spent with her.

Three months later, at the court hearing, I was found negligent and ordered to pay a fine of 10,000 rupees ($115) to the court. At the hearing, I met Chinnammal’s grandson. I hugged him, and though he barely spoke, I could feel the warmth of his forgiveness – just like that of his paati’s.

In her dying moments, Chinnammal taught me the value of life – every life.

Chinnammal means “small mother”.

A neighbour who had known her said, “She spent her whole life caring for her daughter, and, even in death, she ensured that her family was taken care of [with her savings]. Her mind and body may have given in, but she never stopped being a mother.”

This story was told to Catherine Gilon by Maverick Prem. Information about Chinnammal’s life was gathered from interviews with her former neighbours, who asked not to be named. Her family declined to be interviewed for this story.

Maverick continues to pay his respects to Chinnammal at the temple grounds where she spent her final years. In addition to the court fine, he made a voluntary donation to Chinnammal’s grandson.