AS I SEE IT
BY MARIANNE HERON
Like most, when I pop off, I would like to have a peaceful departure. But, although death itself is certain, there is no certainty about how it may come about. I hope, as we all do, to be able to die with dignity, pass away peacefully in my sleep or cease instantly with a heart attack but there is no telling what GR, the Grim Reaper, may have in store for me.
If I were to have a nasty prognosis would palliative care be effective enough for the symptoms to be borne? Hopefully it would but, if it didn’t, I might like to have a choice; it’s a choice which the late, brave Vicki Phelan pointed out was not a choice between living and dying when you have a terminal illness but a choice to end the suffering. At present the only way to do this, while I am still able to travel, would be avail of Dignitas in Switzerland or end things myself.
But this situation may change shortly. Last month the Oireachtas Committee on Assisted Dying recommended that the Government legislate for assisted dying or euthanasia with those who have only six months to live or 12 months for those suffering from neurogenerative disease.
The committee’s recommendations are strict; the law should apply only where the illness is progressive, incurable and terminal and where palliative care cannot relieve suffering in a way that is tolerable for the individual. Two doctors should be involved in the decision making with a conscientious objection opt-out.
Inevitably, the recommendation will give rise to many conversations and arguments. It is an emotional subject, arousing strong feelings for and against. Both the College of Physicians and the College of Psychiatrists are against introducing the measure, the former holding that legislation would run contrary to medical ethics. “We believe it will place vulnerable people at risk, and will lead to harmful consequences, such as an increase in the numbers requesting euthanasia or assisted suicide,” they say.
They argue that requests to end life may be due to other causes other than physical suffering, such as depression, fear, loneliness (surely forms of torment) or a wish not to be a burden to carers.
It does sound to me as though the medics, with their superior knowledge, claim the right to make life or death decisions without their patients having much of a say.
There is the slippery slope argument and it does seem that, once the door to voluntary assisted dying (VAD) is opened, it can widen. Canada for instance, where Medically Assisted Dying (MAD) – an unfortunate acronym – was legalised in 2016 and saw an increase in legally assisted deaths in 2022 of 31% over the previous year. Next year the legislation there will be extended to allow assisted dying for those whose sole condition is mental illness and where funding may not be given to hospices where MAD is not an option.
It is now over a decade since the death of Marie Fleming, who suffered from terminal multiple sclerosis, and whose challenge to the law criminalising assisted suicide in the Supreme Court paved the way for the Oireachtas Committee and their proposals. “We hope that the Government will have the commitment to follow through and not to kick the can any further down the road. People who are terminally ill don’t have time to waste,” says Janie Lazar, Chair of End of Life Ireland.
The organisation believes in giving individuals control over their deaths in the same way that they have control over other aspects life and that having the choice to die at home on their own terms is a fundamental human right.
“Once people have been approved of VAD in certain cases Their quality of life improves, with the knowledge that they can end their life gives them peace of mind, the legislation will also protect doctors,” says Janie Lazar. ”What are the alternatives? If people take their own lives, it can go horribly wrong.”
In the US state of Oregon, where VAD has been available for 20 years, research found one third of those approved for the procedure didn’t go ahead but benefitted from the comfort of having a choice.
Whether or not the the legislation will be passed in the life of the current Dail remains to be seen. One thing I hope is that TDs who don’t agree with the measure for themselves will consider is that if they vote against it may take the choice of dying with dignity away from others.
