THE FACT OF THE MATTER
BY PAUL HOPKINS
Swiss organisation Dignitas has called on Ireland to change the law on assisted dying – a debate growing here since 2018. Dignitas, which supports voluntary assisted dying, told a recent hearing of the Oireachtas Committee on Assisted Dying, set up last January, that it had 100 Irish members.
Two representatives of Dignitas – Ludwig Minelli and Silvan Lumley – said in a submitted statement: “Voluntary assisted dying should be legalised as a choice alongside other options to soothe suffering and improve quality of life, be it palliative care or hospice work.”
The European Court of Human Rights, in a judgment as far back as January 2011, held that “it is an individual’s right to decide by what means and at what point his or her life will end, provided he or she is capable of freely reaching that decision”.
However, Dr Theo Boer, Professor of Healthcare Ethics at Groningen University in the Netherlands, told the Oireachtas committee he “switched from being moderately supportive of the Dutch law to being increasingly critical”. His “scepticism” had arisen from the introduction of [an updated] euthanasia, in which a doctor administers the fatal drug, as opposed to the patient taking the medication themselves.
Dr Boer said: “The [updated] legalisation has turned the whole landscape of dying, including our view of illness, suffering, ageing, and care-dependence upside down. In the slipstream of legal euthanasia, the percentage of people dying through terminal sedation has skyrocketed to 25% of all deaths in 2o22 – where most other developed countries would come no higher than 2%.”
The committee heard that 12 people from Ireland had availed of assisted dying with the Swiss clinic since 2003.
Dignitas has members from around 100 countries and assists in about 200 to 250 suicides annually. More women than men seek the service but less than 50 per cent are terminally ill at the time.
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. Defenders of such might argue that the duty to prevent suffering makes the policy persuasive. A reasoned response would be that, while suffering and loss of independence are undesirable, only the person enduring such should decide if it is unbearable. Provided, the patient is competent to decide.
The same argument can be advanced against the current practice, prevalent in most countries, of prohibiting people from seeking assistance to end their lives. 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 is, too, the question of a relative of someone with serious dementia signing off that person – without their ability to consent – to assisted dying. Legally dangerous ground here.
When my Father died, my Mother knew there was no going back. She didn’t want to go on. She was in stage four of an incurable cancer. Being of sound mind, she told the doctor she didn’t want to take any more medicine. “Keep it for the young people,” she told him.
“I’ve had a good life,” she quietly told me.
So, one blue-skied day in September of the Millennium year, with my siblings and I by her side, she slipped into a coma, the loving hospice nurse cradling my Mother’s shrunken head in her lap. A few days later, my Mother died, peacefully and relatively pain-free – 10 weeks after her husband. More than that though, at 82 years, with an incurable disease, she chose her own time of going, along with that last vestige of humankind, her dignity. Was her going not a passive euthanasia of sorts, practised already in our wonderfully caring hospices?
While assisted dying is illegal in Ireland, under Irish law, adults have the right to refuse medical treatment, even if required to save their lives, as long as they have the ability to understand the information to make such a decision.
In the 35 years since renowned GP Paddy Leahy first broached the subject, only now are we having a substantial public debate on the matter. Right and proper – if ensnared with potential conflict. It’s a human rights issue.
Ethically, we should have the right to control our own bodies and the State should not have laws that prevent those who wish to choose when and how they die from doing so.
And with their dignity unsullied …