‘Ana’ blog by Ana Estrada

On January 16, 2019, the Peruvian psychologist Ana Milagros Estrada Ugarte, known as Ana Estrada, posted the first entry of her personal WordPress blog, titled ‘Ana’. The blog’s URL ‘AnaBuscaLaMuerteDigna’ (Ana seeks a dignified death) would become a rallying cry for those who believe individuals should have the right to determine the moment of their own deaths. Born in 1976, Estrada noticed the first symptoms of a degenerative disease at 12 years of age, when she could not unbend her left arm during a swimming class; two years later she was diagnosed with polymyositis, an autoimmune disease that would eventually paralyze most of her body. In her late thirties, Estrada’s respiratory muscles began to lose strength. After spending 6 excruciating months hospitalized in intensive- and intermediate-care units (an experience she details in her blog), Estrada would require permanent care as of 2016. Though she benefited from a program that allowed her to be at home and still have her mechanical ventilation covered by public healthcare, Estrada no longer had the privacy and autonomy she prized in life. She then started advocating for her right to die by posting personal essays, poems, and research analyses on her blog – using her right index finger, the only one she could still move, to type and click; and she would do so until March 14, 2024, the date of her last post. As a reviewer puts it, ‘her texts take our breath away, challenging and disarming us’ – and they soon gathered public attention, offering readers a candid portrait of palliative care, insights into the inner life of a psychologist dealing with mortality, and a public forum to discuss the ethics and legality of assisted dying. Ten months after the initial post, Estrada’s case started appearing in newspapers; an early report mentions the blog had received hundreds of comments, some suggesting Estrada should kill herself, to which she replied, refusing the implication of a violent and extrajudicial death: ‘I don’t want to leave as a suicide, as someone who commits something illegal’.

Besides documenting Estrada’s life with polymyositis, her blog became a chronicle of her legal battle for an assisted death. In November 2019, taking Estrada’s blogged narrative as evidence, the Ombudsman’s Office decided to represent Estrada in court and plead for her right to die. In January 2020, they filed a request for the non-application of article 112 of Peru’s Penal Code (which typifies merciful killing) to Estrada’s case, arguing the law violated her fundamental rights and posed a real threat of her suffering cruel treatment. Additionally, they requested that an interdisciplinary Medical Board be created to advise on the right to die and that the Ministry of Health be compelled to respect Estrada’s eventual decision, validate the Board’s proposed plan, and issue a directive regulating euthanasia in similar situations. In February 2021, Lima’s Eleventh Constitutional Court ruled in favour of Estrada, granting the non-application of article 112 to her case and agreeing to most of her additional requests (save for the regulation of similar cases) – and the sentence would be ratified by the Supreme Court in July 2022. On April 21, 2024, Estrada became the first person in Peru to die by legal euthanasia, at the age of 47. The Supreme Court ruling cites Estrada’s blog multiple times, including her account of traumatic experiences while in intensive care and her clear viewpoint: ‘I believe there is no greater gesture of love than helping and supporting a loved one find their death and put an end to their suffering.’ In one of her last posts, Estrada thanks Josefina Miró Quesada Gayoso, who was part of the Ombudsman’s team and the lawyer of María Benito in another high-profile case involving the right to die. Even if Estrada was granted an exception to the law, instead of its overhauling, her legal victory has already served as a precedent for the case of María Benito – who died on May 3, 2024, after successfully requesting the removal of a mechanical ventilator that artificially kept her alive. Interest groups such as Acción por Igualdad and the Due Process of Law Foundation have underscored the importance of Estrada’s words to defend what they categorize as an emerging human right, not only in Peru, but in Latin America as a whole.