Introducing assisted suicide 'entirely radical'

A leading Irish palliative care specialist has told the High Court he supports the total ban on assisted suicide here and believes it would be “entirely radical” for doctors “to try and kill pain by killing patients”.

Dr Tony O’Brien said the ban made the situation “crystal clear” for doctors and he feared its removal could result in vulnerable people opting to have their lives ended only so as not to be a burden on others. It was “quite impossible” to devise safeguards to protect such people and “nothing could be safer” than the ban.

A UK palliative care specialist, Prof Rob George, said offering the option of interfering in the dying process through assisted suicide “completely reclassifies the role of medicine” and “changes society fundamentally” as it involved reclassifying the intentional ending of a person’s life, at their request, as “a societally mandated good”.

This led to a “slippery slope” or “paradigm shift”, as in the Netherlands, where what started as voluntary euthanasia later became involuntary for those without capacity on grounds it was in their best interests and the possibility of offering euthanasia to children was now being discussed.

If assisted suicide were allowed for one group, there was an obligation to look to others who sought it and it also created a “moral hazard” for those who assisted in taking a life as they might suffer unforeseen consequences themselves.

Opponents in UK

In the UK, among the most vocal opponents of assisted suicide were disability groups, who believe it involves making assumptions about their quality of life, capacity and value when they are already at the receiving end of assumptions concerning their disabilities, he added.

Both doctors were giving evidence on behalf of the State in the continuing action by Marie Fleming (58) challenging the constitutionality of the ban on assisted suicide in section 2.2 of the Criminal Law Suicide Act.

Ms Fleming, who is in the final stages of multiple sclerosis, also wants orders requiring the DPP to outline the factors to be taken into account in deciding whether to prosecute.

Yesterday Dr O’Brien told Shane Murphy SC, for the State, he had 26 years experience with 30,000 dying or suffering patients, and believed Ms Fleming’s situation might be improved physically, emotionally and spiritually via engagement with palliative services at the highest level here.

When Ronan Murphy SC, for Ms Fleming, said he was instructed she had availed of every palliative care option offered to her and had not refused any treatment, Dr O’Brien said he believed she might benefit by re-engaging with the palliative care services.

Prof George said, by legalising assisted suicide, the notion of killing someone as a solution to a problem was being introduced and there is “no knowing where that will go”. Introducing adequate safeguards to prevent errors and abuses was an “insurmountable” task and legalising assisted suicide would lead to deaths of patients who had not expressed a wish to die.

Those jurisdictions that had legalised assisted suicide and euthanasia showed increasing numbers were availing of it, and the figures in the Netherlands were equivalent to 11,000 deaths a year in the UK, he said.

He was concerned about potential for abuse and unintentional coercion of people towards assisted suicide. This was not about “malicious people setting out to kill Grandma” but, for example, full-time family carers unintentionally expressing frustration at the person being cared for.

The case continues.