A Narok couple emptied animal deworming chemicals on their daughter as part of ‘mercy killing’ and was sentenced to 15 years by Justice Momanyi Bwonwonga
Mercy killing or Euthanasia is illegal in Kenya. But aren’t there medical situations when it appears like the better option?
Consider the case of Filbert Ongachi from Butere in Kakamega County. His 19-year-old son, Chris Akosi was left in a vegetative state after a motorbike accident. The choice to continue life support at the Kakamega Referral Hospital —costing upwards of Ksh300,000—became untenable as they had no health insurance coverage.
The peasant farmer turned to relatives, but most offered minimal financial support, besides wishing his son a quick recovery and prayers.
Akosi later died and his body was held in the hospital morgue for three weeks as the family struggled to raise Ksh330,000 in unpaid bills.
“Even if he held on, there was no value he could add to himself or society. He had lost three limbs and was crying all the while when out of pain relievers,” Ongachi recounted, expressing a sentiment echoed across hospital wards filled with patients in Intensive Care and High Dependency Units.
There is no African country that has legalized euthanasia, leaving those wishing to execute mercy killing to do so abroad.
Take the much talked-about case of Diana Elga Akinyi who sought euthanasia abroad when medical bills exceeded Ksh8.4 million due to malignant cancer, a terminal illness.
In 2009, Akinyi suffered a spinal injury from a road accident confining her to a wheelchair. Then came the cancer.
Akinyi’s family struggled to shoulder the costs forcing Akinyi to pursue euthanasia in Switzerland, where mercy killing is legalized. The flight alone cost Ksh430,000 escalating the costs further.
Akinyi’s epitaph at Lang’ata Cemetery which she drafted before her death in 2017, reads: ‘To Live is Christ and to Die is Gain.’
Assisted death or any intentional life-ending act is classified as murder under the Penal Code, leaving patients and families to navigate a rigid legal landscape.
“We simply keep them comfortable under palliative care until the end,” explains Dr Adolf Muyoti. “That is what our law stipulates.”
Dr Muyoti doesn’t approve of mercy killing, but explains in countries where it is permitted, it’s reserved for those enduring extreme and incurable suffering.
Patients with terminal illnesses, like advanced cancer with a short life expectancy, often qualify if their pain cannot be managed by medical means.
Similarly, those with irreversible neurological disorders, like ALS (Amyotrophic Lateral Sclerosis) or late-stage multiple sclerosis, may be eligible due to the progressive loss of bodily functions.
In some countries, patients with chronic, treatment-resistant mental illnesses who face prolonged, unbearable suffering might also qualify, although this is subject to strict regulation.
“Each case undergoes a thorough review by multiple healthcare professionals to ensure informed consent and strict adherence to legal and ethical standards,” says Dr Muyoti. “Nevertheless, I would advise patients in critical conditions to seek a second opinion from a different physician or healthcare facility. I have seen patients once considered beyond hope who eventually recovered.”
In Kenya, about 800,000 people need palliative care annually, according to the Ministry of Health’s statistics for 2021. Majority are patients in terminal stages of a somatic disease like advanced cancer, AIDS and amyotrophic lateral sclerosis.
Unfortunately, only about 14,552 are accessing these services with many Kenyans often struggling to access care due to a combination of limited resources, inadequate healthcare infrastructure, and insufficiently trained professionals.
Many healthcare facilities, particularly in rural areas, lack specialised palliative care units or staff trained to provide pain relief and emotional support to those with life-limiting illnesses. The cost of palliative care services can also be prohibitive, as many treatments are not covered by insurance.
Additionally, cultural and social stigmas around end-of-life care create barriers, with some communities perceiving palliative care as “giving up” rather than enhancing the quality of life according to a 2018 report by the Lancet Commission on Palliative Care and Pain Relief.
This reluctance is compounded by a general lack of awareness among patients and healthcare providers about available palliative care options.
Greater awareness of palliative care programmes and the provision of comprehensive medical coverage by the government could significantly improve access, particularly for children.
Currently, less than five per cent of paediatric patients in need receive palliative care.
Emmanuel Kiprotich Sigei and his wife, Irene Nalomuta Sigei from Nasitori in Narok South Sub-County, did not secure this care, acting on “compassionate” grounds, decided to kill their 18-month-old daughter, Brenda Chepkorir at home.
Emmanuel, 25 and Irene, 23 were sentenced to 15 years in prison in 2019. Justice Momanyi Bwonwonga ruled against their claim of mercy, stating, “Even if the accused thought this type of killing was a form of euthanasia… it is still an offence.”
The postmortem revealed acute gastritis and poisoning as the cause of death after the parents emptied animal deworming chemicals down their daughter’s gut.
Euthanasia is fleshed from the Greek words “eu” and “thanotos,” which literally translates to “good death.”
Is it time we allowed ‘good death’ in Kenya?
In Death with Dignity: Towards the Legalization of Euthanasia in Kenya, his Master’s law thesis published this year, Mutegi Gitonga Kelvin argues that outlawing euthanasia without justification conflicts with the Constitution’s guarantee of inherent dignity, the right to freedom and security of the individual.
Gitonga says these constitutional rights aim to protect individuals from physical or psychological suffering—yet, denying a person the choice of death when it is arguably the most humane option disregards these protections.
Notes Gitonga: “Due to an increase in the number of persons diagnosed with chronic illnesses in the country, there is a dilemma faced by both doctors and patient’s family members on whether to retain a vegetative patient without a chance of recovery on expensive machines at the financial detriment of the patient’s family and the patient’s agony and torture.”
Since euthanasia is illegal in Kenya, patients have only a limited option to sign “do not resuscitate” Gitonga argues. This order (DNR) is a medical directive indicating that a patient does not want resuscitation if they stop breathing or their heart stops beating. This means that in an emergency, healthcare providers will not perform CPR (cardiopulmonary resuscitation), electric shock to the heart, or other life-saving measures to revive the patient.
The other option is palliative sedation- common in countries that have banned euthanasia like Kenya.
Here, medications are given to relieve severe symptoms in terminally ill patients. While it may unintentionally shorten life, the primary focus is pain relief rather than death, adhering to the principle of double effect.
This narrow opening has also caused Kenya to miss a significant opportunity in medical tourism.
Consequently, families with loved ones enduring chronic illnesses thus bear the financial strain of travelling to countries like Belgium, Germany, Colombia, Luxembourg, Spain, New Zealand, the Netherlands, Canada and Australia.
Some 10 states in the USA including Washington DC, California, Colorado, New Mexico, Maine and Oregon, legally permit physicians to assist in ending suffering.
Despite legal prohibitions, euthanasia occurs in many countries, but “it is not clear whether any form of euthanasia goes on in Kenya,” according to The State of the Law on Euthanasia in Kenya by Prof, Dr Moni Wekesa and Dr Martin Awori.
Their 2020 paper published in the Journal of Medical Law and Ethics, notes that euthanasia was practised in ancient days despite prohibitions in the Hippocratic Oath while Christians abetted it secretly even though most considered it murder.
The closest an African country came to legalizing euthanasia was in 2015 when South African lawyer Stransham-Ford, 67, suffered terminal cancer and filed a ground-breaking petition seeking a doctor-assisted death.
Ford, an atheist, died hours before the High Court granted his request, ruling that euthanasia was permissible under certain conditions. But, South Africa’s Supreme Court of Appeal later overturned the ruling, leaving Parliament to legislate.
Ironically, the paper also cites a 1999 study which “showed that 12 per cent of South African doctor assisted terminally ill patients to die and nine per cent had engaged in physician-assisted suicides while 60 per cent had passive euthanasia.”
In Kenya—a nation known for its litigious spirit and the robust 2010 constitution—euthanasia and assisted death are confined to scholarly debate and ethical contemplation.
Allan Odhiambo a sociologist views open talk and massive civic education as the solution to the complex issues of mercy killing, improving palliative care and strengthening end-of-life options in Kenya.
“On mercy killing,” he offers, “we as a nation ought to decide on legal reforms that could allow patients greater autonomy over end-of-life choices. For instance, increasing awareness of “Do Not Resuscitate” (DNR) directives and enhancing legal protections around palliative sedation would allow patients to manage their suffering without the stigma or legal risks associated with mercy killing.”
He adds: “Educational outreach to address cultural stigmas surrounding palliative care is also essential. Providing training for healthcare providers and educating the public could normalize seeking comfort-focused care for terminally ill patients, which can improve quality of life without unnecessary prolongation of suffering. Very few people are aware of palliative care services in the country going by the numbers of those who utilise them.”
