The case is not easy to write about Noelia Castillo without immediately turning into a secondary figure in the cultural battle between supporters and opponents of euthanasia.
It is precisely for this reason that it is necessary to focus on the most inconvenient point: if it is possible to defend euthanasia as a last resort and at the same time consider that Noelia is not exercising this right well, until the cruel recovery of the condition which took an eternity to save his death.
Euthanasia, as understood by liberal democracies, is justified when two cumulative conditions occur. Serious, constant and unbearable suffering and irreversibility of the situation.
The basic idea is simple and reasonable: when you have nothing that medicine can do except prolong the agony, the state should not force anyone to bear it.
This logic is based on a robust conception of personal autonomy and a compassionate awareness of the public voice.
However, putting this principle into practice requires an extremely careful legal and hygienic framework. The organic law 3/2021 on the regulation of euthanasia comes from the legitimate mayor of the parliament, but it also has a clear political urgency: if he chooses the path of the bill, thereby avoiding the most protracted debates and information from advisory bodies that relate to a government project.
The result is a text that loosely defines the term “euthanasia context” and that hardly destroys the most delicate terrain of all, that of mental health.
The standard states “severe and incurable illness” with a prognosis of limited life or “severe, chronic and incapacitating illness”. Don’t mention mental disorders as the main source of the experience for so long explicitly.
It is the courts, and especially the Constitutional Tribunal, that revive this empty place. This form of legislation (leaving gray areas to supplement judicial interpretation) may be permissible in debatable matters. This is not about deciding who can ask the state to end their life.
Applied to Noelia, the letter has been drawn to a limit that forces reflection.
Noelia lasted twenty years. Tras ser violada y un intento de suicide quedó paraplegica.
Noelia also collected diagnoses of depressive disorder and adolescent-limited personality disorder.
Nadie discusses the reality of her suffering. Arguably, it deals with an irreversible framework in the strong sense that justifies the state’s acceptance of all alternatives, that no other salida that helps death.
Contemporary psychiatry has evidence-based treatments for people like Noelia: specific therapies for the limited disorder, trauma treatment, intensive intervention programs, specialized residential courses.
These courses are expensive, expensive and often inaccessible.
But they exist.
There is no indication in the public report of the case that they are offered in a sustainable, structured and prioritized manner. It cannot honestly be said that the system had everything reasonably possible to improve the situation and that it would only activate euthanasia as a last resort after the collapse.
The distinction between philosopher is particularly useful here Joel Feinberg. Feinberg distinguished between first-order desires (“I want to die”) and second-order desires (“I want to be the kind of person who wants to live”).
A person can at some point in life long for death and yet in a deeper feeling long to regain the will to live. The relevant issue is not only that Noelia wants to die (a wish I’ve held onto for years), if so, in different conditions of apoyo, treatment and surroundings, you could have asked for a different thing.
The personal autonomy that justifies euthanasia is not the mere sum of desperate desires, but the ability to make decisions based on information, without external forces and without the internal power of treatment overshadowing any other option.
When a young girl who grew up in a deconstructed family, who went through shelters, who experienced sexual aggression, who has a psychological history of three years, is connected to the conclusion that she does not want to continue living, the state has the duty to think whether this conclusion is the fruit of strong autonomy or accumulated abandonment.
In Noelia’s case, she never faced the rigor she required.
Because guilt is not fulfilled at the moment euthanasia is requested. Fill up a lot beforehand. Use it when the smaller protection services of the Generalitat of Cataluña do not offer you a safe environment or protect you from multiple sexual assaults.
Continue when red de mental health It is not necessary to provide intensive and permanent treatment.
It worsened when the administration as an adult was more effective in dealing with death and guaranteeing access to therapeutic resources.
The contrast is painful: a state that was unable to protect her as a child and care for her as a vulnerable patient He was impeccable in the bureaucratic management of his euthanasia.
Overall, there are political dynamics that make self-criticism difficult. Euthanasia has turned into a sign of identity: it is automatically associated with progress, the specific case is reinterpreted as a concession to religious or conservative attitudes.
And so he read Noelia’s case: as a struggle between a young girl and her father, between the ass and the “ultras”. Everything disappears in this track. Uncertainty of mental health, shortcomings of public protection, better regulation, the risk that euthanasia will be used in practice as before the failure of recourses.
Defender of euthanasia implies acceptance of exceptional qualities. Regardless of how to manage people’s desperation, with adequate help they can live better, until those extreme cases where nothing more can happen.
Describe this boundary and normalize your employees in situations which also allows for alternatives it does not merely violate the spirit of the law until it undermines its legitimacy.
The real promise of society’s humanity is not in the speed with which it provides euthanasia, until the stress that euthanasia presents will never be the result of abandonment.
Only when the state can decide, without violating the truth, that it has everything possible to sustain life, will it have the moral authority to euthanize someone, freely, without compunction.
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