Medics have ‘ethical imperative’ to resist assisted suicide

Academic says portrayal of choosing to die as a ‘noble deed’ often a response to poor care

The medical profession has an “ethical imperative” to say assisted suicide is not how you alleviate suffering, an Oireachtas committee has been told.

Prof Des O’Neill, of the school of medicine at Trinity College, Dublin, said the State and many charities worked together to prevent suicide and address the issues that give rise to it.

He said feelings of insecurity, fear and vulnerability which underpin many suicides were the motivations of some elderly, disabled or depressed people when considering ending their lives.

Prof O’Neill said he regarded assisted suicide as an “almost neoliberal” idea which suggested that suicide among the elderly, disabled and vulnerable was somehow different to suicide among other groups.


He told the Oireachtas Committee on Justice and Equality, which was discussing the right to die with dignity, that behind the expression “I don’t want to be gaga at the end” was a disrespect for disability and a perception of a lack of care for people disabled by age and infirmity.

Many people expressed the idea that they do not want to suffer at the end, but in fact 30 years practise as a geriatrician had shown him that when care was proactive, compassionate and provided dignity “not one of our patients has chosen to die,” he said.

‘Ignoble response’

Prof O’Neill said assisted suicide that is passed off as a “noble deed” is very often an “ignoble response to dreadful patient care.”

He agreed with Fianna Fáil TD Jim O’Callaghan that “there is no legal right to die” and that “people in Ireland do die with dignity”. He said the phase “the right to die with dignity” had been unfortunately “adopted as a synonym for assisted suicide”.

Prof O’Neill said the notion of freedom of conscience among medical practitioners was also being undermined. He said there was pressure on doctors to go along with arguments for assisted suicide and this was “an assault on ethics and it is a very difficult and dark place”.

“We have an ethical imperative to say this is not how we care for people, not how we alleviate suffering,” he said.

However, Dr Louise Campbell of NUI Galway, a philosopher with training in clinical ethics, said she would be “cautiously” in favour of medical assistance with “assisted dying”.

She said she would “empathise” with Prof O’Neill’s views in relation to vulnerable, elderly or disabled people.

However, she said in some cases “the motivation was to end the suffering of the individual at his or her request”. She said the capacity for autonomy, a person’s ability to make decisions based on their own beliefs, was widely recognised within the liberal tradition.

Dr Campbell said proponents of assisted dying argued that those who were “suffering intolerably” should be allowed “to control the manner and timing “ of their dying.

Tim O'Brien

Tim O'Brien

Tim O'Brien is an Irish Times journalist