A vote to note the Report of the Joint Oireachtas Committee on Assisted Dying, which recommended legislation to allow assisted dying, was rushed through before the Dáil was dissolved.
It does not necessarily signal that legislation is on the way, but it is not a good look. Kim Leadbeater’s private member’s Bill, The Terminally Ill Adults (End of Life) Bill, successfully passing its second reading in the British Parliament on November 29th, may add to the impetus. Some 3,400 doctors, nurses and healthcare professionals wrote an open letter warning of the dangers of introducing assisted dying when the NHS is broken.
Gino Kenny had his second Private Members’ Bill tabled here to legislate for assisted dying, which fell with the Dáil’s dissolution. Kenny’s failure to be re-elected does not mean the issue will not be revisited.
Advocates for changing the legislation usually insist that there is a clear distinction between suicide and assisted dying. Yet to facilitate euthanasia, legislation concerning assistance to someone dying by suicide has to be amended to render it legal in certain circumstances.
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David Albert Jones of the Anscombe Catholic bioethics centre has also shown that suicide rates rise where assisted suicide is legalised – although “this increase in non-assisted suicide was mostly non-significant when socio-demographic factors were controlled for”. Troublingly, however, studies from Switzerland and Oregon reported elevated rates of self-initiated death among older women. For example, by 2022, Belgium had the highest rate of female non-assisted suicide in Europe.
Perhaps you cannot legislate for assisted dying without normalising the idea that some lives are not worth living.
In the UK Leadbeater’s Bill has a long way to go before becoming law but the second reading was rushed, with only five hours allocated for debate. As the equality regulator, the UK Equality and Human Rights Commission (EHRC) provided an advance briefing. While the EHRC is neutral on assisted dying, it was hard-hitting. For example, it noted that a Private Members’ Bill is exempt from the requirement on government ministers to provide evidence of compatibility with human rights and equality.
EHRC strongly recommended that nonetheless, at the earliest opportunity, compatibility with human rights should be demonstrated. While Leadbeater and others had insisted it had no implications for disabled people, again, the EHRC did not concur, stating that there is not always a clear line between terminal illness and disability, and that the rights and protections of disabled people must be at the forefront.
Citing a UN expert, it stated that coercion was not just an individual problem, because “people with disabilities, older persons, and especially older persons with disabilities, may feel subtly pressured to end their lives prematurely due to attitudinal barriers as well as the lack of appropriate services and support”. It noted the patchy provision of “high-quality palliative care”.
There was also criticism from other unexpected sources, such as Lord Sumption, a former Justice of the Supreme Court, who reluctantly favours legalisation. He bluntly states that “the result of allowing assisted suicide is bound to be its progressive normalisation as an available exit route”.
He describes parts of the legislation as “over-engineered, bureaucratic, and coldly inhumane ... [and reading] like a protocol for an execution”.
Leadbeater did not endear herself to the judiciary by claiming that it supported the Bill, for which she was forced to apologise. She made other inaccurate statements, including that “not one jurisdiction that has passed laws based on terminal illness has expanded its scope”.
What about Canada, where 4.1 per cent now have assisted deaths and which now allows euthanasia for loneliness, anorexia and suicidal ideation? Or Belgium, which has expanded its law to include children?
The UK legislation is based on Oregon, the alleged paragon, but since 2010, it has sanctioned assisted dying for non-terminal illnesses, such as arthritis, complications from a fall, hernia and anorexia.
Citing feeling like a burden (which Leadbeater approves of as a reason) has risen from a third to nearly half. Twenty-eight per cent were referred for psychiatric evaluation to rule out depressive illness when legislation commenced. Now it is less than 1 per cent.
Oregon destroys all source records a year after each annual report. It also includes eye-popping statistics in its annual report without comment, such as that one person took 137 hours to die in 2023, after ingesting the provided lethal drugs.
Leadbeater’s well-intentioned legislation is deeply flawed. Families cannot object; doctors cannot truly opt out, as they must refer to another doctor; there is no obligation, as there is even for a tonsillectomy, to explain that the procedure has risks other than the obvious one of death, such as vomiting up the drugs or slipping into a coma.
In Ireland disability groups are vehemently opposed to legalisation, as are the Irish Association of Palliative Care, the Irish Palliative Care Consultants’ Association, the Royal College of Physicians and the College of Psychiatrists of Ireland. The Irish College of General Practitioners is neutral but admits that even among those who favour it, the support is passive with little indication of any desire to be actively involved in taking lives.
The last government recently published an important strategy on palliative care. Instead of foisting assisted suicide on healthcare professionals who don’t want it, and vulnerable people who deserve better, why don’t we do something really progressive by prioritising palliative care?