Last week, a spokeperson for Fianna Fáil told the Medical Independent that
they would not oppose the referral of assisted suicide to a Citizens’ Assembly
for further discussion. Delegating the debate to an unelected body means that
neither Fianna Fáil, nor any other major
party, is not actively opposing the introduction of legislation that could
legalise euthanasia and assisted suicide.
In 2017 the Oireachtas Joint Committee on Justice and Equality
considered possible recommendations on legislating in favour of euthanasia andassisted suicide. They heard from a number of experts, and the strongest
opposition to the introduction of new liberalising laws came from the
representatives of the medical profession and of disability advocacy groups.
Des O’Neill, professor of medical gerontology at Trinity College
Dublin, said “We have to send out a message to people of disability of whatever
age that our impulse is to care, to cure sometimes, to relieve often and
comfort always.”
Dr Regina McQuillan of the Irish Association of Palliative Care
said: “Suicide is rightly considered a blight on society and there are many
efforts made to reduce it. That there are some people for whom suicide is
considered appropriate may suggest that there are people whose lives are not
deserving of the same level of protection.”
At the end of the hearings, the Committee did not achieve a clear
consensus. Accordingly, they did not recommend legislative change. Instead, they urged the Houses of the
Oireachtas “to consider referring the issue to the Citizens’ Assembly fordeliberation”.
But why should a non-representative body, with no specific
expertise, discuss and recommend vicariously, when there was no majority in the
Oireachtas Committee in support of the change?
Political parties cannot stay neutral and delegate to others such
a critical debate. Even small changes must be opposed or they will have
catastrophic effects.
We can learn from the experience of other countries that the
legislation on these issues is usually introduced on some limited ground (for terminally
ill patients, for instance) but, with time, it becomes more and more liberal.
Once the general principle that doctors should not participate in procuring
death is eroded, it is difficult to change the trend and go back.
Psychiatrist Mark Komrad has said, “Several governments, in the
last two decades, have invited and permitted physicians to transgress the
prohibition against killing their patients. … Originally, the class who can be voluntarily
killed or helped to suicide was limited to those at the very end of life.
However, principles of justice have made it very difficult to limit such
procedures to that category of people. The more experience a country has with
such practices, the more the horizon of eligibility has expanded far beyond
extreme end-stage cases. … The so-called “choice“ that is offered to the
suffering to end their lives is a pseudo-choice, filtered through a physician’s
own values, and commonly forced, by having very limited choices in other
domains — economics, social support, healthcare, etc. It is unjust, and
therefore impossible, in a democratic society, to limit these procedures to
some — like the terminally ill — but refuse it to others — like those with chronic
physical and psychiatric disabilities. Yet, it signals that chronic disability
and its sufferings might constitute a “life not worth living.”
The pressure on doctors to support and participate in euthanasia
and assisted suicide is growing everywhere.
In October 2018, at the General Assembly of the World Medical Association
(WMA), representatives from Canada and the Netherlands attempted to change the
WMA code of ethics, which has always condemned the participation of physicians
in procuring death through direct euthanasia or providing drugs for suicide.
During the debate, all sort of euthanasic practices were rejected
and eventually the proposal has been withdrawn, reiterating the WMA’s
long-standing opposition to procuring death.
This debate, though, continues on national level.
The Royal College of Physicians (RCP), in the UK, has recently
dropped its opposition to assisted dying in a surreptitious manner that has
attracted strong criticism. They are now neutral on the issue and will not
officially engage in public discussions but how they have arrived at this
position appears to be despicable.
In 2014, 57.6% of the RCP membership opposed a change in the law
that would legalise assisted suicide. In January this year, after
announcing the third poll on this topic among its members since 2006, it was decreed
that a 60% majority was needed to stop changing the RCP position to
non-opposition. This means that even if 59,9% were against the change, it would
have occurred nonetheless. Such a majority was even more difficult to achieve
as three options were given (yes, no or neutral), while the previous vote was
binary (yes or no).
A group of members of the RCP have challenged them in court, arguing
that “the use of a ‘super-majority’ vote on such issues is without precedent in
professional organisations in the UK. They have said that it appears to be a
tactical move to give a strong boost to the campaign to change the law on
assisted suicide. The largest euthanasia lobby group in the UK has previously
identified the opposition of medical bodies as a key obstacle to changing to
law. Two well-known patrons of this organisation, and active campaigners for
legalising euthanasia, are
on the RCP Council – the
internal body driving the RCP poll.”
In spite of the robust protestation, the poll was carried out in
February and found that 43.4 pc were opposed adopting a pro-assisted suicide policy,
31.6 pc were in favour and 25 pc were neutral. This means that even though the
majority of the voters were against, the Royal College of Physicians will now
be neutral on the matter.
In this case, as with the Joint Committee referral to the
Citizens’ Assembly, we see that even when there is no clear majority in support
for a significant change, certain issues are considered so important by a
minority that they have to be promoted, under the disguise of neutrality, until
they are accepted.
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