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Bill proposes extreme euthanasia regime for Isle of Man

An assisted suicide and euthanasia bill, more radical than any similar legislation in the US or recently proposed in the UK, will be debated later this month in the Isle of Man.

The ‘Assisted Dying Bill 2023‘ is set to receive a Second Reading in the House of Keys, the lower house of the Parliament of the Isle of Man, Tynwald, on 31 October. 

The Bill will not only allow for assisted suicide, in which a person ends their own life through taking lethal drugs, but also for euthanasia, in which a person’s life is ended by a medical professional.

According to the Bill, the lethal drugs can be prescribed by the attending doctor or “another registered medical practitioner”, including nurses and pharmacists, if they have been authorised to do so by their doctor.

Assisted suicide and euthanasia bill

The Bill goes further than other similar legislation in the US insofar as it permits a doctor, or other medical practitioner authorised by the doctor, to end the life of the patient directly, rather than only supplying the patient with the means to end their own life.

Similarly in other jurisdictions in the UK, recent bills that have been brought forward by assisted suicide campaigners have been limited to only allowing assisted suicide and would not allow euthanasia. 

The UK Parliament has repeatedly rejected recent attempts by assisted suicide campaigners to introduce a law to England and Wales that would be more restrictive than what is being proposed on the Isle of Man, only allowing assisted suicide. 

Most recently attempts to change the law were rejected in the House of Commons in 2015 and the House of Lords in 2022.

The Bill states: “The person for whom medicine has been prescribed under subsection (1) must decide whether to self-administer the medicine or to request an assisting health professional to administer the medicine to them on their behalf”.

As recently as 2015, the Tynwald rejected an assisted suicide Bill by 17 votes to 5, and in 2020 threw out a motion to change the law on assisted suicide, voting to ‘note the debate’ instead. 

According to a public consultation undertaken from December 2022 to January 2023, 49.61% of participants opposed the introduction of assisted suicide into the Isle of Man, compared with 49.01% who were in favour of it.

Suicide tourism

The assisted suicide and euthanasia Bill on the Isle of Man permits an individual who has been diagnosed with a terminal illness that is “an inevitably progressive condition which cannot be reversed by treatment” and as a result of which, the individual can be “expected to die within 6 months” to end their lives by assisted suicide or euthanasia.

Anyone wishing to end their lives under this Bill must have been resident on the island for at least one year. Similar residency requirements in the state of Oregon were recently removed leading to concerns about ‘suicide tourism’. 

It is possible that, if this Bill passed, there would be pressure for a similar loosening of the law in the Isle of Man, especially given assisted suicide and euthanasia are not available in England, Wales, Scotland or Northern Ireland. 

The Association for Palliative Medicine has opposed the legalisation of assisted suicide on the basis that “assessing capacity is extremely complex and estimating prognosis is unreliable”.

Research from the Marie Curie Palliative Care Research Department at University College London in 2016 found that the accuracy of prognoses for terminal illness can range from 78% to a mere 23%.

Expansion of euthanasia law

In Canada, ‘Medical Assistance In Dying’ (MAID) was legalised in 2016 for the terminally ill but the requirement for death to be “reasonably foreseeable” was removed in 2021. Canada has also approved, in principle, the extension of MAID to include people with mental illness and is considering including minors in its eligibility criteria.

If this legislation becomes law, it is likely that the eligibility criteria for those seeking to end their lives proposed by this Bill will be challenged by campaigners through a human rights challenge whereby permitting assisted dying for one group of people but not others could be considered discriminatory.

Lobbyists are already seeking to expand the eligibility criteria in the Bill on the Isle of Man to include “incurable and intolerable suffering”. In the Netherlands, this criteria has been used to permit the ending of a woman’s life who had tinnitus.

Right To Life UK spokesperson, Catherine Robinson, said “The Isle of Man should learn from the mistakes of other jurisdictions that have already introduced these practices. The introduction of euthanasia in this Bill completely changes the relationship between the patient and their physician who will be able to offer death as a form of ‘treatment'”.

“While this Bill and others like it attempt to create safeguards against coercion, it is impossible to guard against more subtle forms of pressure that tend to exert themselves upon vulnerable people. The data on assisted suicide and euthanasia in Canada shows that 35% of people who ended their lives by an assisted suicide or euthanasia report being at least partly motivated by being a “perceived burden on family, friends or caregivers”.”

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