A radical Private Members’ Bill attempting to legalise assisted suicide in the Republic of Ireland has been introduced in the lower house of Ireland’s parliament.
The so-called ‘Dying with Dignity Bill’ was tabled in the Dáil Éireann by People Before Profit TD Gino Kenny on Tuesday 15 September.
Although Kenny’s party only has five members, other parties have indicated they could support the proposed law, with any vote likely to be an issue of conscience.
The ‘Dying with Dignity’ bill was first introduced by TD John Halligan in 2015 but ran out of time when the Irish government was dissolved in 2016.
Analysis by Naoise Grenham, Public Affairs Officer at Right To Life UK
There is an abundance of alarming aspects to a radical Bill which lurches far beyond the demands of the assisted suicide campaigners Dignity in Dying in the United Kingdom and the supposedly exemplary legislation of Oregon, USA, which this neighbouring campaign claims to emulate.
Most notably, Gino Kenny’s Bill allows for euthanasia in cases where “it is not possible” for the patient to administer themselves lethal drugs.
Such actions are expressly forbidden under both the Death with Dignity Act implemented in Oregon in 1997 and the similar proposals of 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 “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.
‘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 Ioana 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.
No proper protection for conscience rights
In addition to David’s concerns, the bill would force healthcare professionals who have a conscientious objection to assisted suicide to make “arrangements for the transfer of care of the qualifying person”, a form of participation that goes against an individual’s conscience rights.
This is especially worrying for the hospice movement, which cares for patients near the end of their lives and is philosophically opposed to euthanasia.
In stark contrast, the archetypal Death with Dignity Act in Oregon does not require healthcare professionals to transfer such patients but only to transfer their records once the patients have themselves located a new provider.
‘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.”
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.”
Negative culture change
Peadar Tóibín, the leader of the pro-life Aontú party, has warned that in countries that have introduced physician-assisted suicide or euthanasia, “pressure starts to grow on older people and people with severe disabilities.”
“So much so that countries such as Canada, Netherlands and Belgium have seen the number avail of assisted suicide radically increase,” he told News Letter.
“These countries initially introduced assisted suicide for a small number of really difficult cases but have now seen the numbers increase nine and ten-fold. Requests for euthanasia are extremely rare before it’s made legal but radically increase when the culture changes,” Tóibín continued.
He also said the bill could “radically change” the direction of the medical profession from the saving of life to ending it.
“We urge the government to assist people with living. To invest the necessary resources to ensure that people who are faced with difficult death have all the supports that they need to make for final journey as comfortable and pain free as humanly possible. We need to improve our palliative care and our health service but euthanasia is not the solution to the failings in our health system,” he said.