Ireland advances assisted suicide Bill after rejecting opportunity to further scrutinise it

Politicians in the Republic of Ireland have rejected an opportunity to refer a radical assisted suicide Bill to a special committee which would assess the legislation’s impact and report back within 12 months, by 86 to 65 votes.

Instead, the so-called ‘Dying with Dignity’ Bill was voted through to committee stage by 81 votes to 71. The Justice Committee now has the chance to amend the proposed legislation to be more or less severe.

Seven of the coalition Government’s Cabinet ministers were among those who voted in favour of the Bill, including the Tánaiste Leo Varadkar, Justice Minister Helen McEntee, Health Minister Stephen Donnelly and Higher Education Minister Simon Harris.

Voices against assisted suicide silenced

In response to the votes, Aontu leader Peadar Toibin decried the lack of scrutiny and said the manner in which the bill was passed was shocking.

The Meath West TD noted that out of 75 minutes of debate, only 4 minutes were given to those who opposed the bill.

In an apparent departure from the established norm, all speaking slots were filled before the bill reached the floor of the chamber, with deputies in favour of the radical proposals having taken them all.

Ten minutes from the end, Mr Toibin called a point of order and appealed for more time, noting the irony of the one-sided debate: “I welcome that all the speakers so far have said we need a proper discussion about this very serious issue. It would be a shame to go through the Second Stage debate without anybody with an opposing view on the Bill getting a chance to speak, and with all the views exactly the same”.

Deputy Mattie McGrath also questioned the distribution of speaking slots and called the debate “shambolic”.

Despite the protests, the Chair refused a request to extend the 75-minute debate by 20 minutes to allow more contributions.

However, 4 minutes were afforded to Independent TD Peter Fitzpatrick to make the case against assisted suicide.

The TD for Louth said: “The Bill before us this evening would open up the door to one of the most extreme regimes anywhere in the world…

“The amount of correspondence I have received in recent days from healthcare professionals is unbelievable. They all raise serious concerns about the impact a change in the law in this area would have on the very vulnerable people in the area. Away from the soft-focus interviews that many in the media have been conducting on this issue in recent weeks, there are people all around Ireland who have been listening to this debate and are disconcerted and upset by what they have heard.

“The message the medical professions have been sending to Deputies in recent days is loud and clear. The impact of what is said in debates like this and the changes to the law in the area can be devastating for the most vulnerable and fragile members of our community who oftentimes start to see themselves as a burden on society with a duty to end their lives. We must listen to what the experts are saying in this regard.”

‘Wrong in principle’

The latest proposal to allow assisted suicide has been criticised by palliative care doctors, geriatricians, politicians and pro-life campaigners.

Columnist and head of the Dublin-based Iona Institute, David Quinn, condemned the Bill for being both “wrong in principle” and for having “incredibly far-reaching” proposals which go further than other countries that allow assisted suicide.

“For example, the definition of ‘terminal illness’ is so broad it could include dementia. It does not require that a person be within a set period of death such as six months. Therefore, the person could be in the early stages of a terminal illness with years of life remaining and still ask a doctor for a lethal drug. They only have to make the request once,” he told Crux.

‘A better option’

Professor Anthony O’Brien, a Clinical Professor of Palliative Medicine at University College Cork with over 35 years of experience in hospice care, has spoken out against the Bill, telling The Irish Times: “I have met very many patients who in desperation asked to have their life ended, believing that they had no other option. With good palliative care, the overwhelming majority had occasion to change their minds. With suicide, there is no going back.

“Surely a compassionate society can be more creative in its response to human suffering than premature, self-inflicted death. Good care is always a better option.”

‘Regressive step’

Hope Ireland, a coalition of healthcare professionals and disability rights advocates, says the introduction of assisted suicide and euthanasia is a “regressive step for vulnerable people – particularly the elderly and those with disabilities”.

In their briefing document, which was sent to all of Ireland’s TDs, they highlight how the operation of similar laws in other countries have shown the consequences of legalisation are “catastrophic” for older people and people with disabilities.

For example, they state:  “In 2019, a woman with dementia who revoked her consent to be euthanised had to be held down by her family whilst the doctor ended her life. A Dutch court approved this practice, and acquitted the doctor of any wrongdoing.”

Analysis by Naoise Graham, Public Affairs Officer at Right To Life UK

There is an abundance of alarming aspects to the radical Bill, which goes far beyond the demands of Dignity in Dying, the assisted suicide campaigners in the United Kingdom, and the supposedly exemplary legislation of Oregon, USA, which this campaign claims to emulate.

Most notably, Gino Kenny’s Bill allows for euthanasia in cases where “it is not possible” for the patient to self administer lethal drugs. 

Such actions are expressly forbidden under both the Death with Dignity Act implemented in Oregon in 1997 and the similar proposals from Dignity in Dying.

A host of other provisions illustrate the extremity of the Dying with Dignity Bill, even among the radical company of Oregon and Dignity in Dying.

The Oregon law defines terminal illness as expected to “within reasonable medical judgement, produce death within six months”. 

In contrast, the Bill before the Irish Parliament lacks any time limit for terminal illness, only requiring that the patient be ‘likely to die as a result of that illness or complications’ at an unspecified stage.

Whereas Oregon patients supply both written and oral requests for lethal drugs, Kenny’s Bill reduces the procedure to only a single written declaration. 

Similarly, only one witness would be needed to sign off on patient declarations under the radical Irish proposal, as opposed to two witnesses under the American legislation of much longer experience. 

Unlike in Oregon, Kenny’s Bill does not stipulate that the patient be recommended to inform their next of kin of their decision.

Under the ‘Dying with Dignity’ Bill, the waiting period between a patient’s declaration to end their own life and the prescription of lethal drugs reduces from fourteen to six days in cases where death from a terminal illness is deemed likely to occur within a month. 

In contrast, the Oregon system of assisted suicide only collapses the 15-day waiting period if death from a terminal illness is likely to occur within that period.

Whereas the Death with Dignity Act in Oregon insists that any informed decision must involve consideration of “feasible alternatives, including, but not limited to, comfort care, hospice care and pain control”, Gino Kenny’s ‘Dying with Dignity’ Bill fails to detail the mandatory information for patients beyond the simple mention of “the available choices”. 

Perhaps most strikingly, the ‘Dying with Dignity’ Bill makes no reference to the possibility of psychological or psychiatric evaluation in case of potentially impaired judgement on the part of the patient. This represents a disturbing distinction with Oregon where the physicians are obliged to refer such patients for counselling.