The legality of a living will remains uncertain in South Africa. A letter of intent to introduce a bill, the National Health Amendment Bill, was published in the Official Gazette in July 2018. The purpose of this bill is to create legal recognition, legal certainty and enforceability with respect to living wills such as living wills and continuing powers of attorney for the health sector. With a permanent power of attorney, a substitute decision-maker is chosen by the patient, while he or she can make competent decisions to act on his or her behalf if the patient becomes incapable. The bill has certain limitations and there is always the possibility of conflicts, even with existing living wills, but one of the objectives is to provide for the resolution of disputes related to these guidelines.13 This bill has been submitted to the National Assembly for consideration as the insertion of sections 7A and 7B into the National Health Act No. 61 of 2003, Amendment 41789. This change may reassure patients that their wishes will be fulfilled and give doctors legal certainty, but since its introduction in Parliament, it has become obsolete and it is unclear whether it will be revived.14 The euthanasia debate has again made headlines, as reported by various South African newspapers in 2019 when Professor Sean Davison was charged with triple murder. He was given an 8-year suspended sentence with house arrest and community service after securing a court-approved plea in the Western Cape High Court. His compassionate motivation to help these people die with dignity, their pleas for his assistance in dying, supported by their loved ones, and his remorse were all seen as mitigating factors. This case came 44 years after a similar case in 1975, in which Dr. Hartman assisted in the death of his 87-year-old father from terminal cancer. He was also given a suspended sentence, and the similarities between these two cases indicate that there has been no significant progress in legal developments on euthanasia since 1975.6 Assisted suicide laws have already been developed and proposed, but not enacted, and they are currently still illegal in South Africa. Project 86 of the South African Legal Commission published a report entitled « Euthanasia and Artificial Preservation of Life » in November 1998.
This bill from the South African Law Commission is a bill to regulate end-of-life decisions and related matters. The Commission did not make specific recommendations on voluntary active euthanasia, but presented various options for obtaining legal clarification on how to deal with this issue. This law has not yet been finalized, despite enormous legal and legal efforts.7 The Court noted that there are only four countries in the world that allow physician-assisted euthanasia. If the common law is to be developed, it must be tackled head-on and the scope and scope of the required deviation from existing principles defined. This issue was not identified by the High Court as an issue for consideration by the High Court and was therefore not thoroughly and appropriately considered by the Court. The Supreme Court of Appeal said that an order that makes such a profound change to our homicide law should not have been made without regard to applicable principles. In 2022, Svend Lings, a Danish doctor who helped at least 10 patients die, was convicted of helping two people die and a third suicide attempt. His medical license was revoked and he was sentenced to 60 days in jail. Lings appealed his conviction to the European Court of Human Rights, saying he had only legally provided information to patients. ECHU upheld Lings` conviction on the grounds that he had provided the lethal medicines to patients, which went beyond disseminating legal information.
Luxembourg was the third country in Europe, after the Netherlands and Belgium, to legalise euthanasia and physician-assisted suicide. The Act was adopted by Parliament on 19 February 2008 and entered into force in April 2009. Under the law, doctors enjoy legal immunity from punishment and prosecution for euthanasia or physician-assisted suicide if a patient with a « serious and incurable illness » has repeatedly requested the procedure.