A landmark legal battle that could redefine how South Africans face death is now before the courts, as DignitySA launches a constitutional challenge to legalise medically assisted dying.
The organisation has approached the North Gauteng High Court in Pretoria, seeking to overturn South Africa’s long-standing common-law prohibition on assisted dying. At the heart of the case is a fundamental question: should individuals enduring unbearable and irreversible suffering have the legal right to choose how and when they die?
DignitySA’s application argues that the current legal framework is inconsistent with key constitutional rights, including dignity, equality, bodily autonomy and freedom. The case marks the culmination of 15 years of advocacy aimed at securing what the organisation calls “the last right” for South Africans.
Chairperson and co-founder Willem Landman says the law, as it stands, fails those facing the most extreme medical conditions. He argues that human dignity is deeply compromised when individuals lose control over the manner of their death.
“Our Constitution looks compassionately upon those who face terrible deaths,” Landman said, adding that the courts must recognise the suffering caused by forcing patients to endure prolonged and irreversible pain against their will.
DignitySA defines assisted dying as a medically supervised process that may be either self-administered or carried out by a healthcare professional. However, it stresses that any such system would be tightly regulated, with strict eligibility criteria and safeguards to protect vulnerable individuals.
Under the proposed framework, only mentally competent adults suffering from incurable and irremediable conditions would qualify. Patients would also need to make voluntary and informed requests, ensuring that the decision is free from coercion.
The organisation is asking the High Court to declare the blanket ban unconstitutional and invalid. It is also seeking an order compelling Parliament to introduce legislation within 24 months to regulate assisted dying. During this period, DignitySA proposes that the declaration of invalidity be suspended to allow lawmakers time to craft a comprehensive legal framework.
Spokesperson Vuya Ilengou emphasised that assisted dying should not replace palliative care but rather complement it. While advances in pain management have improved end-of-life care, Ilengou said some patients still experience suffering that cannot be alleviated.
“Palliative care is essential, but it cannot always mitigate the all-consuming suffering some patients endure,” Ilengou explained.
The case is supported by medical experts who argue that, when properly regulated, assisted dying aligns with the ethical principles of compassion and patient autonomy. DignitySA says its application includes evidence from both local practitioners and international specialists, pointing to systems in at least six countries where assisted dying is legally practised under strict controls.
The application also draws on real-life case studies to illustrate the human cost of the current legal position. These include individuals who took drastic steps to end their lives, as well as others who travelled abroad to jurisdictions where assisted dying is permitted.
Among them is Mario Oriani-Ambrosini, a former member of Parliament who died by suicide after battling terminal illness, and patients who sought assistance in countries like Switzerland. DignitySA argues these cases highlight what it calls “enforced suffering” under existing laws.
The respondents cited in the case include the Minister of Justice and Constitutional Development, the National Director of Public Prosecutions, the Minister of Health and the Health Professions Council of South Africa. These institutions will be required to defend the current legal position and respond to claims that it violates constitutional protections.
This is not the first time the issue has surfaced in South Africa. Parliament has been aware of debates around assisted dying since at least 1998, yet no comprehensive legislation has been introduced. DignitySA argues that this prolonged inaction has left a significant gap between constitutional rights and the reality faced by terminally ill patients.
The outcome of the case could have far-reaching implications, not only for healthcare and legal practice but also for societal attitudes toward death and dying. If successful, it would place South Africa among a growing number of countries reconsidering how to balance the sanctity of life with the right to die with dignity.
As the legal process unfolds, the case is expected to spark intense public debate, raising profound ethical, medical and constitutional questions about life, suffering and personal choice in a democratic society.
