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Prohibition against “the deliberate killing of a patient” removed from Irish Medical Council ethical guidance

The Irish Medical Council (IMC) has removed a prohibition against “the deliberate killing of a patient” from its most up-to-date guide to professional conduct and ethics.

Where the eighth edition, released in 2016, in its section on End of Life Care contains the explicit prohibition “You must not take part in the deliberate killing of a patient”, the ninth edition of the Guide to Professional Conduct & Ethics for Registered Medical Practitioners, released at the beginning of the year, contains no such prohibition on the deliberate killing of patients.

By contrast, the most recent General Medical Council in the UK has specific guidance for end of life care, which states “This guidance takes account of, and is consistent with, current law across the UK, including… the law prohibiting killing (including euthanasia) and assisted suicide”. 

According to the IMC, the Guide to Professional Conduct & Ethics for Registered Medical Practitioners “seeks to support doctors by providing principles-based guidance on how to best work in partnership with patients”.

It goes on to add “The Guide is also useful for patients as it clarifies the standards of care they should expect from their doctor”.

Assisted suicide and euthanasia are currently illegal in Ireland

A euthanasia and assisted suicide bill was introduced in 2020 in Ireland but failed to make its way through the legislature. 

In January 2023, the Irish Government formed a Joint Committee on Assisted Dying, which was formed to “consider and make recommendations for legislative and policy change relating to a statutory right to assist a person to end his or her life (assisted dying) and a statutory right to receive such assistance”.

Doctors in Ireland are largely opposed to the introduction of assisted suicide

The IMC’s move towards allowing for assisted suicide and euthanasia is radically out of step with other medical bodies in Ireland. The Royal College of Physicians in Ireland (RCPI) has stated its opposition to assisted suicide and euthanasia in its most recent position statement on the matter and reiterated that opposition to the Joint Committee on Assisted Dying last year.

The College of Psychiatrists of Ireland is also opposed to the legalisation of euthanasia and assisted suicide.

Study finds that the “wish to die” is often “transient”

In 2021, a study that examined the attitudes and opinions of physicians in Ireland found that only 14% of physicians surveyed were in favour of introducing euthanasia into Ireland. 

Just 17% were supportive of introducing physician-assisted suicide. A majority opposed the legalisation of euthanasia (67.2%) and physician-assisted suicide (56.3%).

A 2021 study in Ireland found that almost three-quarters of people over 50 who had previously expressed a wish to die no longer had that desire two years later. The Irish Longitudinal Study on Ageing (TILDA), surveyed 8,174 people over the age of 50 and found that 3.5% expressed a wish to die at Wave 1 of the study.

However, as the report states: “Seventy-two per cent of these participants no longer reported a wish to die when reassessed 2 years later”.

Researchers behind the study from Trinity College Dublin found that the “wish to die” among older people is often “transient” and linked with depression and feelings of loneliness. 

Furthermore, TILDA found that 60% of those who reported a wish to die also had “clinically significant” depressive symptoms while half had been diagnosed with depression.

Spokesperson for Right To Life UK, Catherine Robinson, said “The removal of the explicit prohibition against physicians deliberately ending the lives of their patients in the Irish Medical Council’s most recent guidelines is alarming. As if it is a fait accompli, the IMC appears to be paving the way for a change in the law on assisted suicide and euthanasia in Ireland”.

“The IMC appears to have learned nothing from other jurisdictions that have already made assisted suicide or euthanasia legal, nor have they learned anything from research in their own country”.

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