A matter of life, and death with dignity



It’s a matter of life and death – specifically euthanasia, the right to have a say in your time of going. And we really need to talk about it. Thankfully, we finally are. An Oireachtas committee is in session examining both sides of any potential legislation to allow people with terminal illness – and in excruciating, permanent pain – have a right to choose to end their lives.

It seems, though, we’re caught between the rock and the hard place.

Picture a society in which patients are routinely euthanised — whether they want their lives to end or not — if their suffering cannot be alleviated without dulling their consciousness, eradicating their independence, or dismissing their dignity. In such a society, defenders of such might argue that the duty to prevent suffering and indignity makes the policy persuasive. A reasoned response would be that, while suffering, indignity and loss of independence are undesirable, only the person enduring such should decide if it is unbearable.

If a patient is competent to decide, nobody other than that patient should have the authority to decide whether life is worth continuing.

The same argument, however, can be advanced against the current practice, prevalent in most countries, of prohibiting people from seeking assistance to end their lives. Although some might decide that the suffering that marks their lives is not sufficient to make life not worth continuing, others would deem their condition unbearable.

And so the conundrum. Just as it would be wrong to entice people to ‘let go’, it would be wrong to force people to endure conditions they deem unbearable.

There was a time on this island when we didn’t talk about cancer; a time when we didn’t talk about suicide; a time when we didn’t talk about our mental health; and a time when we did not talk about gender issues. Thank God, as a society we have grown up. However, in a society where we are living longer thanks to medical science and better nutrition and hygiene, living longer can bring its downside in that ageing could still bring potential illness or just the old body and mind breaking down slowly, with its attendant pain and suffering.

We really need to talk about ageing, dying and death itself. Raging against the dying of the light, to borrow from Dylan Thomas, serves no purpose at all.

The decision about whether to continue living in such debilitating conditions is among the most important we can make.

The right to life and the right to die are not two rights, but two aspects of the same right. The right to life is the right to decide whether one will or will not continue living. The right to die is the right to decide whether to die, when one could continue living. If the right to life were only a right to decide to continue living and did not also include a right to decide not to continue living, then it would be a ‘duty’ to live rather than a ‘right’ to life. The idea that there is a duty to continue living, regardless of how bad life has become, is, sadly, an implausible one as I see it.

Any new law on assisted dying should be based on “reasonable medical judgment” that there is a high probability a person will die within a certain set time, according to Sinead Gibney, Chief Commissioner with the Irish Human Rights and Equality Commission, who was responding to questions at the first meeting of the Oireachtas committee examining assisted dying.

She said robust safeguards to protect the most vulnerable would need to be in place if any law allowing for assisted dying were introduced. These included people with disabilities, people with life-limiting illnesses, people who may be in relationships where coercive control is exerted, and older people.

The committee on assisted dying, which will sit for up to nine months, may or may not make a recommendation to the Dáil and the Seanad on this highly sensitive and complex issue.

It is 35 years since renowned GP Paddy Leahy first broached the subject on the Late Late Show, and only now are we beginning the debate on the matter. And it needs to be a careful and considered conversation. It’s a human rights issue. Ethically, we should have the right to control our own body and the State should not create laws that prevent those who wish to choose when and how they die from doing so.

With, hopefully, that last vestige of human kind, their dignity, intact.

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