Ireland has a chance to learn from other countries on assisted dying

In October 2020, Nancy Russell, aged 90 and described by her family as exceptionally social and spry, chose Medical Assistance in Dying (Maid) in Toronto. She could not face another two-week Covid 19 lockdown confined to her nursing home room while being denied all social interaction.

She spent eight days in one of her children’s homes before her death, making her farewells. She then died, surrounded by her family singing a song she had chosen.

In a terrifying distortion of values, Russell was permitted companionship while a doctor caused her death but not companionship that would have kept her alive.

Speaking of macabre, an independent Canadian report emerged in 2020 on the costs of expanding Maid to those whose natural death was not “reasonably foreseeable” and those who could not give explicit consent at the time but had previously given consent.

We should not forget the Christian minority in Palestine and Israel

---

Are the mistakes of Junior Cycle reform about to be repeated in the Leaving Cert?

---

‘Commendable’, ‘meticulous’ and ‘intricate’: the giveaways that students have been using AI

---

How a US university that prides itself on freedom of speech dealt with student protests over Gaza

---

While stating that the savings should not be used as an argument, it concluded there would be a net cost reduction for provincial governments of $86.9 million. It estimated that each death would require four hours and 20 minutes of physicians’ time, including the first and second assessments and the administration of lethal drugs. Two of those four hours and 20 minutes would be taken up with paperwork post-death and registering the death.

This touching faith in Irish exceptionalism might be more convincing if we did not have our near neighbours in the Netherlands and Belgium to demonstrate to us just how misplaced that confidence is

The immediate reaction from those in Ireland who advocate for assisted dying and euthanasia is that we are not Canada, that Russell’s situation could never happen here and that any legislation would be only for the terminally ill and robust safeguards would be in place.

This touching faith in Irish exceptionalism might be more convincing if we did not have our near neighbours in the Netherlands and Belgium to demonstrate to us just how misplaced that confidence is. They thought they were just as exceptional and yet, over the years, euthanasia has become available for those with disabilities and chronic illness, the mentally ill, those no longer able to give consent and children.

Theo Boer, a well-known Dutch ethicist agrees with euthanasia in tightly prescribed circumstances. He initially approved of the 2002 Dutch euthanasia laws. He worked for an oversight body from 2005 to 2014, until the work meant that he could no longer sleep at night. For example, he was haunted by the person told by his oncologist that he had nothing in his future except pain, pain, pain, without ever being told of palliative options.

[ Breda O’Brien: Euthanasia is not a slippery slope. It’s a precipice ]

Boer believes attitudes towards euthanasia have changed from the last resort to “a beautiful way to die”. He and Stef Groenewoud, a professor of healthcare ethics at Kampen University in the Netherlands have published a book, Leven Met Euthanasie (Living with Euthanasia), arguing that the slippery slope is real and decorated with the trappings of justice. Furthermore, euthanasia is often neither dignified nor beautiful and undermines palliative care systems.

A new Special Oireachtas Committee recently met for the first time to consider assisted dying. Senator Rónán Mullen, a committee member, makes a valid point about the terms of reference. The committee is “to consider and make recommendations for legislative and/or policy change in relation to a statutory right to assist a person to end their life (assisted dying)”. Mullen wants the terms of reference to explicitly acknowledge that this does not preclude making recommendations to maintain our current legislation.

The Irish Palliative Medicine Consultants’ Association (IPMCA) has similar concerns about the terms of reference. IPMCA states that it has “deep-rooted and urgent concerns about the harmful consequences to society should an assisted dying regime be introduced”.

Mullen also wants the committee title to be changed to Assisted Dying/Assisted Suicide, to reflect a balanced approach. Any legislative change proposed by the committee would demand amendments to the Criminal Law (Suicide) Act 1993. This bolsters the suggestion that “assisted suicide” should be included in the committee title.

This committee provides an opportunity for Michael Healy-Rae, the committee chairman who is perceived as a conservative, to model what impartiality looks like by being scrupulously fair to all sides. The evidence will speak for itself, but if emotive personal testimonies supporting assisted dying are allowed to dominate, it will be a travesty.

[ Draft legislation on widening euthanasia access in the Netherlands is blocked ]

The emotive cases that demonstrate the flaws in euthanasia will not be able to compete because the central protagonists will be dead, like the cases involving people suffering from mental illness, suicidal tendencies, poverty and loneliness, or the protesting woman with dementia held down while euthanasia drugs were administered.

Independent TD Gino Kenny’s 2020 Dying with Dignity Bill, although well-meaning, was recognised by the Justice Committee to lack safeguards and contain technical errors.

The Justice Committee sought submissions on Kenny’s Bill. The subsequent report is illuminating. The majority of both individual medical submissions and those from medical stakeholders focusing on mental health issues and palliative care opposed Kenny’s Bill and the principle of legislating for assisted suicide/assisted dying.

In spite of assurances of robust safeguards, in other jurisdictions euthanasia and assisted dying have gradually become normalised and more widely available, exerting subtle and not-so-subtle pressure on the vulnerable. This includes an egregious Canadian case where a Paralympian veteran was offered assisted suicide instead of the wheelchair ramp she had sought for five years. Ireland has a chance to learn from this dismal history.