Draft law amending the Health Services Organisation Act, the Unemployment Insurance Act, and other related acts, and amending the Disability Support Act (604 SE) – third reading
Session: 15th Riigikogu, 5th session, plenary session
Date: 2025-06-18 21:43
Participating Politicians:
Total Speeches: 21
Membership: 15
Agenda Duration: 21m
AI Summaries: 21/21 Speeches (100.0%)
Analysis: Structured Analysis
Politicians Speaking Time
Politicians
Analysis
Summary
The Riigikogu held the third reading of Bill 604, initiated by the Government of the Republic, concerning the amendment of the Health Services Organisation Act, the amendment of the Unemployment Insurance Act and related amendments to other acts, and the amendment of the Work Ability Allowance Act, which primarily addressed the regulation of end-of-life declarations of will. Representatives of the parliamentary groups participated in the debates.
Irja Lutsar, speaking on behalf of the Eesti 200 parliamentary group, emphasized that the bill gives people the opportunity to express their will regarding future treatment in a situation where the brain functions minimally and the quality of life does not meet the patient's wishes. She confirmed that this is neither euthanasia nor assisted suicide, but rather the protection of human autonomy. Lauri Laats, representative of the Centre Party, criticized the priority given to the bill, highlighting serious shortcomings in the Estonian healthcare system, such as long waiting lists for treatment and insufficient palliative care, and argued that primary healthcare must be fixed before legalizing end-of-life declarations of will. Margit Sutrop, representative of the Reform Party, supported the bill, noting that it protects people's freedom and dignity and gives doctors the courage to stop so-called "futile treatment," which merely prolongs the dying process. Priit Sibul, representative of the Isamaa parliamentary group, was not against the substance of the bill, as it does not grant new rights but improves the accessibility of the declaration of will to medical professionals, but he expressed concern about the "slippery slope" towards euthanasia that it entails and the ambiguity of a simple written declaration of will. Following the debates, the final vote on the bill was held.
Decisions Made 1
Bill 604, the draft Act initiated by the Government of the Republic concerning the amendment of the Health Services Organization Act, the Unemployment Insurance Act, the Act amending other related acts, and the Act amending the Work Ability Allowance Act, was passed into law with 53 votes in favor, 7 votes against, and 2 abstentions.
Most Active Speaker
Margit Sutrop (Reform Party, right-wing) was one of the most active speakers, presenting thorough and passionate support for the draft legislation, emphasizing its importance in protecting patient autonomy and dignity, and ensuring clarity in the actions of physicians.
Esimees Lauri Hussar
AI Summary
The Riigikogu proceeds to the tenth item on the agenda—Draft Bill 604, which amends the Health Services Organization Act, as well as the related Unemployment Insurance Act and the Work Ability Allowance Act. This is the time for the third reading. The floor is now open for debate, and colleague Irja Lutsar is invited to the Riigikogu rostrum.
Esimees Lauri Hussar
AI Summary
Chairman Lauri Hussar moved the Riigikogu on to the tenth item on the agenda, which was the third reading of Draft Bill 604 concerning amendments to the laws on the organization of health care services and work ability support. He thereby opened the debate and gave the floor to Irja Lutsar, the representative of the Eesti 200 faction.
Irja Lutsar
Profiling Eesti 200 fraktsioonAI Summary
Modern medicine makes it possible to keep vital organs functioning even when brain activity is minimal. Therefore, it is crucial to prepare an advance directive (or living will) and ensure it is accessible to both family members and healthcare providers, so that the individual can make their own decisions regarding future treatment.
Esimees Lauri Hussar
AI Summary
Chairman Lauri Hussar requested silence in the hall and asked everyone to respect the speaker so that we could listen and he could continue.
Irja Lutsar
Profiling Eesti 200 fraktsioonAI Summary
Irja Lutsar emphasizes that an end-of-life declaration is an expression of a person’s free will, which ensures that their wishes are respected by the individual themselves, their loved ones, and doctors, and which can be changed during their lifetime. She stresses that this is neither assisted suicide nor euthanasia, and although the adoption of the law does not immediately mean the legalization of these practices, clear regulation is necessary, along with simultaneous improvements in the quality and accessibility of palliative care.
Irja Lutsar
Profiling Eesti 200 fraktsioonAI Summary
Irja Lutsar firmly supports the End-of-Life Declaration Act, which ensures that an individual's wishes are respected while simultaneously alleviating the heavy burden of decision-making for both relatives and doctors. She emphasizes that this represents a person's free will, which can be changed during their lifetime, and stresses that it is neither assisted suicide nor euthanasia. Furthermore, the speaker expresses hope that assisted suicide, which is currently unregulated, will also be properly organized at the legislative level, and that the quality of palliative care will be improved.
Esimees Lauri Hussar
AI Summary
Chairman Lauri Hussar requests one more minute.
Irja Lutsar
Profiling Eesti 200 fraktsioonAI Summary
Irja Lutsar stressed that Bill 604 is carefully considered and crucial, granting autonomy to individuals who wish to decide the scope of their treatment and care at the end of life, without restricting those who choose not to intervene. Eesti 200 subsequently urged all Riigikogu members to respect individual autonomy and vote for the passage of this bill.
Esimees Lauri Hussar
AI Summary
The Chairman thanks the speaker and, on behalf of the Centre Party faction, requests that colleague Lauri Laats be called to the Riigikogu podium.
Lauri Laats
Profiling Eesti Keskerakonna fraktsioonAI Summary
Lauri Laats emphasizes that the Estonian healthcare system is in serious difficulties and requires primary, substantive reforms—specifically, improving the timely and quality availability of treatment, improving funding, and strengthening palliative care and home care services. Furthermore, the Centre Party will not support the bill until the end-of-life declaration is legalized.
Lauri Laats
Profiling Eesti Keskerakonna fraktsioonAI Summary
Lauri Laats emphasizes that the Centre Party does not support prioritizing the draft bill concerning end-of-life declarations, because the Estonian healthcare system is, according to data from the World Health Organization, the European Commission, and the National Audit Office, facing serious difficulties. It is struggling with long waiting lists for treatment, high out-of-pocket costs, and deficiencies in the availability of quality medical care, which is why it is necessary first to ensure timely and necessary treatment for everyone and to develop palliative care.
Esimees Lauri Hussar
AI Summary
Chairman Lauri Hussar offers his thanks and, on behalf of the Reform Party faction, invites colleague Margit Sutrop to the Riigikogu rostrum.
Margit Sutrop
Profiling Eesti Reformierakonna fraktsioonAI Summary
Margit Sutrop emphasizes that a carefully considered legislative bill protects people's freedom, dignity, and autonomy when making end-of-life decisions. It gives doctors the courage to cease futile treatment that merely prolongs the dying process, rather than life itself. The aim of the bill is to prevent suffering and ensure a dignified death, demanding a shift in mindset among physicians, where the patient's best interests are paramount, rather than simply extending life through life support. The Reform Party supports this crucial step toward protecting individual self-determination.
Margit Sutrop
Profiling Eesti Reformierakonna fraktsioonAI Summary
Margit Sutrop emphasized that the current bill protects the individual’s freedom, dignity, and autonomy, and mandates that the doctor assess the patient’s best interests. It allows, based on informed consent, for the termination of treatment that pointlessly prolongs life and for the avoidance of suffering, but it does not permit euthanasia or assisted suicide.
Esimees Lauri Hussar
AI Summary
Chairman Lauri Hussar asks for one more minute.
Margit Sutrop
Profiling Eesti Reformierakonna fraktsioonAI Summary
Margit Sutrop emphasized that making an end-of-life declaration, with a doctor's consultation, is voluntary and patients can change it at any time. Furthermore, during a meeting last week with hospital managers, members of ethics committees, and representatives of the University of Tartu Faculty of Medicine, participants jointly concluded that doctor training is necessary. This training would ensure they are able to advise patients, answer questions, and take into account the varying needs of specialists. Ultimately, if the law is adopted, doctors will be better equipped to perform their duties.
Esimees Lauri Hussar
AI Summary
Chairman Lauri Hussar offers his thanks and, on behalf of the Isamaa faction, invites his colleague Priit Sibul to the podium.
Priit Sibul
Profiling Isamaa fraktsioonAI Summary
Priit Sibul stated that while the draft legislation has significant merit and improves healthcare professionals' access to the patient's wishes, he cannot approve it in its current form. This is because it might increase the risks of assisted suicide and euthanasia, and it lacks concrete, understandable regulations; he will nevertheless not vote against it.
Esimees Lauri Hussar
AI Summary
Chairman Lauri Hussar closed the debate due to the lack of requests to speak and, following the proposal of the lead committee, proceeded to conduct the final vote on the comprehensive bill initiated by the Government of the Republic. The bill concerns amendments to the laws governing the organization of health care services, unemployment insurance, and work ability allowance. He then asked the members of the Riigikogu to cast their votes.
Esimees Lauri Hussar
AI Summary
Chairman Lauri Hussar announced that the negotiations have concluded and the Government-initiated Act on the Organization of Health Services, along with its related amendments (Draft 604), would be submitted for the Riigikogu's final vote, requesting members to state their position and cast their votes.
Esimees Lauri Hussar
AI Summary
Bill 604 was passed into law: 53 in favor, 7 against, and 2 abstentions.