The case of Catalina Giraldo has opened an unprecedented legal dispute in Colombia over the right to medically assisted suicide. At 30 years old, this psychologist became the first person to formally request the procedure in the country, a practice that is not illegal but still lacks regulation within the health system.
Her request was rejected by her insurer precisely because of that regulatory gap. The refusal triggered a legal battle that is now in the hands of the Constitutional Court, which will have to decide whether the state must allow the procedure in her case or establish clear rules to apply it in Colombia.
It should be noted that Giraldo rejected euthanasia, a practice that is regulated in the country, because she does not want any doctor to assist her in the process and explicitly asks to be the one who carries out her own death through medication.
The case has generated an important debate in Colombian society and among lawmakers, who are divided between the right to die with dignity and the protocols on how to address decisions related to severe mental illnesses.
Colombia’s first assisted suicide request meets regulatory gap
Catalina Giraldo Silva has lived for years with severe mental disorders that, according to her testimony, have marked her life with persistent suffering. She has been diagnosed with major depression, borderline personality disorder and chronic anxiety, conditions that she says she has not been able to relieve despite various psychiatric treatments and therapies.
Her decision to request medically assisted suicide did not arise, she says, from a moment of sudden despair, but from a prolonged process of reflection. For years she has gone through deep emotional crises, hospitalizations and episodes of self-harm that, she says, led her to conclude that she does not want to continue living under those conditions.
Faced with that situation, which was reported yesterday by the local outlet Noticias Caracol on television, she decided to seek an alternative that would allow her to end her life in a controlled and accompanied way. Her goal, she explained, is to avoid a solitary or violent death and to be able to say goodbye to her family in a medically supervised environment.
After years of dealing with her mental illness, Giraldo said the suffering it caused led her to make this drastic decision, although she clarified that it had been carefully considered over a long period. “It’s like a feeling of emptiness with life, like there is no meaning, like something is wrong. I feel that emptiness physically, I feel it in my chest and it hurts,” she said in an interview with the aforementioned television outlet.
The formal request was submitted in October of last year to her health insurance provider. The response was negative. The insurer argued that, although medically assisted suicide is no longer punishable under criminal law in Colombia following a judicial decision, the country still lacks rules regulating how the procedure should be carried out within the health system.
That regulatory vacuum, caused by the absence of explicit legislation from Congress, left Giraldo without a medical pathway to access what she considers her right to a dignified death.
Assisted suicide and euthanasia: two different figures
The case has also brought to the forefront a distinction that often creates confusion in public debate: the difference between medically assisted suicide and euthanasia.
In assisted suicide, the patient performs the final act that causes their death. Medical personnel provide the medication and supervise the process to ensure that it is carried out voluntarily and safely, but it is the person themselves who administers the drugs.
Euthanasia works differently. In that procedure, a doctor directly administers the medication that causes the patient’s death, always under regulated conditions and with the person’s explicit consent.
Colombia has had a regulatory framework for euthanasia for several years. The country was a pioneer in Latin America in allowing the procedure under specific medical protocols and with oversight from the health system.
Assisted suicide, by contrast, is in a different situation. In 2022, the Constitutional Court eliminated the crime that punished doctors who helped a patient die under certain conditions. However, the state has not yet established the rules that would allow that decision to be applied in practice.
Giraldo has rejected euthanasia as an alternative in her case. Her request focuses exclusively on medically assisted suicide because she wants to be the one who administers the medication that would end her life.
A legal battle that reached the Constitutional Court
After receiving the refusal from her insurer, Giraldo decided to go to court. With the support of her lawyer, she filed a legal action called a tutela, a constitutional mechanism used in Colombia to claim the immediate protection of fundamental rights.
The legal strategy seeks for the courts to recognize that the absence of regulation cannot prevent the exercise of a right that is no longer criminalized. According to her defense, the state has the obligation to guarantee the conditions for that right to be exercised.
The first judicial ruling was not favorable to her request. The judge considered that, given the lack of official protocols, it was not possible to order the procedure to be carried out within the health system. The decision was appealed and the case ended up before the Constitutional Court, the highest court responsible for interpreting Colombia’s Constitution.
The court must now decide whether to order health authorities to allow assisted suicide in this case or require the state to develop clear regulations that would allow it to be applied in the future.
The ruling could have implications that go far beyond Giraldo’s individual situation. A favorable decision could force the health system to establish medical and legal protocols for medically assisted suicide, opening the door to new requests in the country.
While the court studies the case, the debate is intensifying. Some sectors warn about the risks of allowing this type of procedure for people with psychiatric disorders, arguing that these illnesses can affect decision-making.
Others maintain that denying that possibility means ignoring the profound suffering that certain treatment-resistant mental illnesses can cause.
Amid that discussion, Catalina Giraldo awaits a judicial response that could redefine the limits of the right to die with dignity in Colombia. Her case, the first of its kind in the country, has put the legal system’s ability to respond to a reality that legislation has not yet managed to regulate to the test.