A Painful Path to a Profound Decision

On Monday, 17 November 2025, nearly two years after he first announced his intention to seek a medically assisted death, Nairobi resident Joe Mudukiza is choosing to live. Diagnosed with sickle cell disease at just six months old, Mudukiza has endured a lifetime of excruciating pain, a battle that led him to make arrangements to travel to Belgium, where euthanasia is legal. His initial decision, publicised in early 2024, sent shockwaves through Kenya, a nation where the practice is illegal and culturally contentious.

"I was convinced to continue living by the many people who reached out after the interview, including my mum," Mudukiza stated in a recent interview. "I also stopped that process because of my children." His change of heart came after an outpouring of public support, which included interventions from the Ministry of Health and the Kenya Hospices and Palliative Care Association (KEHPCA), who pledged medical, psychological, and spiritual support. Despite this renewed hope, his struggle is far from over. Doctors have recently warned that his body's functions are beginning to shut down, and he requires an urgent hip replacement to avert a life-threatening situation within the next 90 days.

The Legal and Ethical Void in Kenya

Mudukiza's case casts a harsh spotlight on Kenya's legal and medical landscape regarding end-of-life care. The Constitution of Kenya 2010, under Article 26, unequivocally states that "every person has the right to life" and that life begins at conception. This constitutional provision forms the bedrock of the country's legal stance, rendering any form of euthanasia or physician-assisted suicide illegal. The Penal Code classifies any intentional act to end a life as murder or manslaughter, leaving no room for medically assisted dying.

This legal rigidity means that for patients with terminal or chronic, debilitating illnesses, the options are severely limited. While a "Do Not Resuscitate" (DNR) order is a potential option, it is a passive measure and distinct from the active intervention of euthanasia. Legal and medical experts note that the conversation in Kenya is largely confined to academic and ethical debates, with no legislative momentum to change the status quo. This contrasts sharply with a growing number of countries, including Canada, Belgium, the Netherlands, and Spain, which have legalized the practice under strict regulations.

Palliative Care: A Critical but Under-Resourced Alternative

The debate ignited by Mudukiza's story invariably turns to the state of palliative care in Kenya—the specialized medical care focused on providing relief from the symptoms and stress of a serious illness. According to the Ministry of Health's Kenya Palliative Care Policy 2021-2030, an estimated 800,000 Kenyans require palliative care annually. However, a staggering gap exists, with only about 14,552 people able to access these crucial services. For children, the situation is even more dire, with access below 5%.

The policy framework aims to integrate palliative care into the public health system as part of Universal Health Coverage, but significant challenges remain. These include a shortage of trained healthcare workers, lack of public awareness, and inadequate facilities, particularly in rural areas. While organizations like KEHPCA are working to expand services and training, funding and accessibility remain major hurdles. For many Kenyans suffering from chronic conditions, the lack of robust palliative care means enduring immense pain without adequate support, a factor that can lead individuals like Mudukiza to consider desperate measures.

A National Dialogue Begins

Joe Mudukiza's journey, from the depths of despair to a fragile hope for the future, has forced a necessary, albeit uncomfortable, national conversation. His experience highlights the profound physical, emotional, and financial toll of chronic illness. It questions whether the country's legal and healthcare systems are adequately equipped to support its most vulnerable citizens at the end of their lives. While his decision to live was influenced by family and a wave of public compassion, his ongoing medical needs underscore the immense challenges that remain.

His story is no longer just about one man's suffering; it has become a case study for patient autonomy, the right to a dignified life, and the urgent need to bridge the vast gap in palliative care services. As Kenya grapples with these complex ethical questions, Mudukiza's fight for life serves as a powerful call to action for policymakers, healthcare providers, and the public to re-evaluate how the nation cares for those in the grip of incurable pain.