As predicted, the Joint Oireachtas Committee on Assisted Dying has recommended the legalisation of assisted suicide and euthanasia in Ireland. It claims they will be allowed under only strict conditions and with proper safeguards, but when you read the actual report, some of the conditions and safeguards seem neither strict nor proper.
The final report from the
Committee, presented last month, includes some criteria to qualify for assisted
suicide and euthanasia, but it also recommends a formal review of the
legislation after three years of operation, when these criteria could be
changed. We all know that they will be changed, as it has happened in other
countries.
Specifically, the report
recommends that so-called “assisted dying” should be offered to adults who are
Irish citizens or have been residents here for at least one year.
In order to qualify, the
person should be “diagnosed with a disease, illness or medical condition that
is: a) both incurable and irreversible; b) advanced, progressive and will cause
death; c) expected to cause death within six months (or, in the case of a
person with a neurodegenerative disease, illness or condition, within 12
months); and d) causing suffering to the person that cannot be relieved in a
manner that the person finds tolerable.”
This is objectionable enough,
but even on its own terms, the report’s recommendations would not create proper
safeguards.
For example, take
Recommendation 28 of the report. It says: “The Committee recommends that two
formal requests for assisted dying must be made, with a set specified interval
between. At least one of these requests must be recorded in writing, and before
two independent witnesses.”
So, two requests have to
be made, only one of which in writing and before two witnesses.
This is extremely loose wording. It does not tell us
whether the two requests must be made to two separate individuals. Could the
two requests be made to the same person?
We are not told that the
person or persons to whom the requests are made should be a doctor. Presumably
they ought to be, but we should be told. Then again, should doctors be involved
in this at all except to confirm that the person is dying and is within a
certain number of months of death?
Who would the
“independent witnesses” be? Two friends? Two strangers? Two lawyers? Who knows?
The report does not
clarify who will assess the requests and, specifically, no mental health
assessment is recommended. It only says that “the doctors have an obligation to
acknowledge receipt of the request and should deliver a response within a
specified timeframe.” According to the recommendations, a qualified
psychiatrist is required only when there are concerns that the person might not
be competent to make an informed decision.
The report recommends an
interval between the two requests, but it does not specify its length. It could
be two weeks or a day. Such intervals are required, in some jurisdictions that
permit assisted suicide or euthanasia, as “cooling off” periods that allow the
patients to reflect about their decision.
There is no requirement
in the report that the family of the patients be informed before the procedure.
In some jurisdictions,
health professionals cannot actively suggest assisted suicide or euthanasia to
their patients as an option, but they can only accept requests coming
spontaneously from patients. This is a protection against patients being
coerced or led towards the procedure.
In the Oireachtas report
there is no recommendation that would stop doctors mentioning ‘assisted dying’
as an option, which is an appalling oversight, or was it deliberate?
The recommended
protections for conscientious protection do not go far enough. Medical
personnel will not be obliged to take part in ‘assisted dying’ but will have to
refer a patient who requests to die in this way to another doctor. This is seen
by many doctors as a form of coerced participation. Institutions are offered no
protection. This means a hospice, for example, could potentially be forced to
allow its patients to die in this way if that is what a patient wants,
regardless of its ethos.
The final report received
approval by nine of the Committee’s fourteen members. Three members voted
against it. Notably, the Chair of the Committee, independent Michael Healy Rae,
voted against, together with Fianna Fail TD Robert Troy and independent Senator
Ronan Mullen. One member of the Committee was absent from the final vote and
one, namely Pa Daly from Sinn Fein, abstained.
The three members who
voted against also presented a minority report, which I will analyse in the
future.
The 38 recommendations in the
report, while extensive, demonstrate a problematic prioritisation of ‘choice’
over the intrinsic value of life and the potential for unintended consequences,
especially for the most vulnerable in society.
The report
ignores the opposition of the main medical organisations in Ireland,
particularly of those medical professionals who work in palliative care.
The report glosses over
the evidence presented by many experts regarding the deeply divisive and
contentious outcomes observed in jurisdictions like the Netherlands, and
Canada, where the slippery slope of criteria expansion and the blurring lines
between voluntary and non-voluntary euthanasia have been well-documented.
Even on their own terms, some
of the recommendations of the report are appallingly lax. The final document has
been barely analysed by a media distracted by the resignation of Leo Varadkar
as Taoiseach, and which tend not to subject euthanasia advocates to proper
critical scrutiny anyway.
In the greater
scheme of things this report, which represents a big step
towards euthanasia and assisted suicide, is far more important than the
resignation of any given Taoiseach. It beckons us to cross a moral rubicon.
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