New laws on doctor-assisted suicide would not provide a "killers' charter" and would give dying patients the conditional right to choose to die with dignity, according to an article in a magazine for Irish GPs.
Mr Patrick Hanafin, a lecturer in Law at the Centre for Legal Studies at the University of Sussex, said in Forum that in discussions about death, the true interest in the story, of the dying person as a person, was lost.
He said AIDS patients, people with cancer, those in a permanent vegetative state (PVS), were "objectified and silenced" in official discourses.
On the one hand, he said, a woman in a PVS could find "relief" through the decision of the courts in her "best interest". But, on the other hand, the AIDS patients or end-stage cancer patients were deemed by society not to be entitled to "relief" to end this suffering. He said behind these two scenarios could lie deep-seated misconceptions about the dying process. "The absurdity of this dichotomy is obvious, yet why do so many struggle to maintain it? Why do we allow death to be appropriated by third parties to their own end? In a society which can struggle so hard to prolong the dying process why do we value the wishes of the dying patients so little," Mr Hanafin wrote in the Irish College of General Practitioners' publication.
He said the current legal conception of the right to die was "woefully inadequate". Not only was there a lack of certainty for all concerned, but the very method - treatment-withdrawal - was not necessarily the most respectful of human autonomy.
Given the ethical opposition on the part of the healthcare professions to treatment-withdrawal, it was highly unlikely patients in such cases might be able to obtain the relief the Supreme Court has decreed in a well-publicised right-to-die case, he said.
"However, if it is in practice almost impossible to secure the right to treatment-withdrawal, then the advocate of physician-assisted suicide for terminally ill patients is faced with a task of
Sisyphean proportions. The question in both cases comes down to respect for human dignity and autonomy. Do we respect these values or not? If not then we should say so explicitly rather than covering up this reality with the empty rhetoric of medical paternalism."
By not allowing such patients access to the means to end their lives with dignity, he said, we were merely saying we did not respect patients to make informed and coherent choices about their own lives. The patient could be trusted to make such important decisions "about what, after all, is their own life".
He referred to the recent media interest in the case of Dr Paddy Leahy, a long time-campaigner for voluntary euthanasia, who expressed a wish to die having been diagnosed as having cancer. "The reaction of traditionalist groups and the conservative majority within the medical and nursing professions mirrored their reaction to the abortion and treatment-withdrawal `controversies'," said Mr Hanafin.
In the UK and Wales, he said, a Green Paper was introduced containing proposals for an extended continuing power of attorney which would enable an individual to nominate a friend or relative to make a healthcare decision on their behalf, should they lose their capacity to do so. "In Ireland, a similar initiative could be adopted which would merely give legislative form to the Supreme Court's decision-making capacity."
He said the issue of physician-assisted suicide would also have to be tackled in order to move away from the current restricted notion of the right to die. "This issue, more than any other, will test whether we are in fact living in a society which is compassionate and tolerant, or one which adheres to bigotry and intolerance."