Autonomy and the End of Life: Reflections from Medicine and the Law

End-of-life decisions (EOLD) represented a complex challenge in the medical, ethical, legal and cultural spheres in Argentina. Despite their frequency in clinical practice, these issues were not addressed in sufficient depth in medical training or in the local scientific literature. From an anthropological point of view, it was observed that Western culture reduced death to a biological fact, in contrast to other cultures that conceived of it as a transition or transformation. Euthanasia, understood as an action or omission to hasten death and avoid suffering, generated a wide-ranging ethical and philosophical debate. Although Thomas More introduced it from a humanist perspective, the term was distorted by the Nazi regime, being used to justify extermination. This provoked strong social and religious resistance, which persisted over time. In Argentina, Law 26.742 allowed patients to refuse disproportionate treatments and to establish advance directives, without authorising active euthanasia. Recent studies and surveys revealed a social shift towards a more secular and autonomous view of the human being, with growing support for the right to decide on the end of life. However, the legal framework has not yet addressed this demand. In view of this, the need for medical education that integrates the bioethical approach, for interdisciplinary work in care and for a legislative debate in line with social changes, in order to guarantee a dignified, autonomous and respectful death, was highlighted.