Agenda Profile: Irja Lutsar

Draft law amending the Health Services Organisation Act (advance directive of a patient’s end-of-life will) – first reading (604 SE)

2025-04-23

15th Riigikogu, 5th session, plenary session

Political Position
Both speakers strongly support the legalization of the Patient's End-of-Life Declaration (PET), highlighting its human-centered approach and respect for individual autonomy. The primary political concern revolves around the bill's indefinite validity period, which is considered dangerous given the rapid advancements in medical science. Speaker 2 (Eesti 200) frames their position through liberal values, stressing that this represents a step in the right direction.

2 Speeches Analyzed
Topic Expertise
Speaker 2 demonstrates profound medical expertise, citing over 45 years of experience in the medical field. They use specific terminology (PET, euthanasia, palliative care) and provide examples of medical advancements, such as the evolving treatment of childhood leukemia. Both speakers emphasize the rapid progress of medical science and its impact on the validity of advance directives over a 60-to-70-year timeframe.

2 Speeches Analyzed
Rhetorical Style
The speech is formal, analytical, and cautious, focusing on logical arguments and future projections. Speaker 2 uses historical medical examples for persuasion and appeals to personal freedom and the reduction of fear concerning the end of life. The tone is supportive of the bill's principles but demanding regarding the correction of its shortcomings (the lack of a time limit).

2 Speeches Analyzed
Activity Patterns
Speaker 2 refers to their participation in the Social Affairs Committee discussions and notes that the bill has been in preparation for years. There is no data regarding the frequency of appearances or other public activities outside of this current sitting.

2 Speeches Analyzed
Opposition Stance
Direct political opponents are not criticized. The criticism is aimed at a specific flaw in the bill—the indefinite period of validity. Speaker 2 clearly distances themselves from the legalization of euthanasia, noting that society is not yet ready for it.

2 Speeches Analyzed
Collaboration Style
The speakers demonstrated a willingness to cooperate, agreeing with previous speakers and the minister that an indefinite declaration of intent is undesirable. Speaker 2 noted that this gives the Social Affairs Committee food for thought, referencing openness to amendments and the need to find consensus.

2 Speeches Analyzed
Regional Focus
The focus is at the national level (the Estonian healthcare system and legislation). Speaker 2 broadens this focus to the international stage, urging increased European and Estonian investment in medical science, while also highlighting concerns about US funding.

2 Speeches Analyzed
Economic Views
There is insufficient data. The economic positions are limited to an appeal to increase state investments in palliative care and medical science.

2 Speeches Analyzed
Social Issues
The central social theme is personal autonomy and the strongly supported right to decide one's own end of life. Emphasis is placed on the fact that the law alleviates the fear of becoming trapped in one's own body. Furthermore, the necessity of ensuring a dignified and suffering-free end of life for everyone, irrespective of the existence of PET, is highlighted.

2 Speeches Analyzed
Legislative Focus
The main legislative priority is supporting and adopting the Act Amending the Health Services Organization Act (Bill 604 SE). A significant focus is finding an amendment proposal that would establish a requirement for the periodic review of the declaration of intent (e.g., after 25–30 years), rather than leaving it indefinite.

2 Speeches Analyzed