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Assisted suicide bill reintroduced for consideration by Irish government

On Tuesday the 15th of September, a Dying with Dignity bill was reintroduced for consideration in the Dáil, the lower house of Ireland’s legislature. At the 7th of October, this bill has passed its first formal vote in the Dáil. 

The bill
The full name of the bill is: ‘Bill entitled an Act to make provision for assistance in achieving a dignified and peaceful end of life to qualifying persons and related matters’. The bill itself can be found here
The bill is focused on assisting in suicide but leaves space for active euthanasia (administration of the lethal substance by the physician) when the patient is not capable to drink or swallow and also in other ways not capable to self-administer the lethal substance. The physician-assisted suicide may only be given in case of a “terminal illness”. Other than in other jurisdictions, like in Australia or the USA, this bill does not set a time limit for an “expected death” (usually 6 months in other countries) but speaks of a situation in which “the person is likely to die as a result of that illness or complications relating thereto”. Another part of the bill is a duty to refer the patient to another doctor when the first doctor is not willing to perform assisted suicide. 

Background
The Dying with Dignity bill was first introduced by TD John Halligan in 2015. When the Irish government was dissolved in 2016, this bill was stalled. When Halligan became a junior minister that same year, he was no longer able to move his own private member’s bill. In 2018, the Bill was considered in a report by Ireland’s Joint Committee on Justice. Ultimately, the committee was unable to come to “a clear consensus as to whether legislative change is justified” and therefore did not recommend legislative change at the time. The Committee did, however, urge the Houses of the Oireachtas to consider referring the issue to the Citizens’ Assembly for deliberation. This September, Gino Kenny, an Irish TD (Teachta Dála; directly translates as Deputy to the Dáil) belonging to the left-wing Solidarity–People Before Profit party, introduced the proposal as a Private Member’s Bill in the Dáil. 

Legal situation in Ireland
According to Ireland’s Health Service Executive (HSE), “Both euthanasia and assisted suicide are illegal under Irish law. Depending on the circumstances, euthanasia is regarded as either manslaughter or murder and is punishable by up to life imprisonment. Assisted suicide is illegal. Attempting to commit suicide in itself is not a criminal act.” According to The Mayo News, the constitutionality of the Criminal Law (Suicide) Act 1993 was upheld in both the High Court and Supreme Court in 2013, in the landmark Fleming v Ireland decision. Whilst the Supreme Court determined that there was no constitutional right to assisted suicide, it did state that the Oireachtas was free to pass legislation regulating it. In 2015 a woman prosecuted in the Dublin Circuit Criminal Court for assisting another person to die by suicide was found not guilty. Passive euthanasia (quickening of the patient’s by removing feeding tubes, etc) is permissible in Ireland since the Supreme Court decision in In Re Ward of Court 1996. The Medical Council Guidelines state in section 46 of its Guide to Professional Conduct and Ethics (8th Edition 2019): 46.9 You must not take part in the deliberate killing of a patient. The ethical guidelines around passive Euthanasia are also given in this section: 46.3 Usually, you will give treatment that is intended to prolong a patient’s life. However, there is no obligation on you to start or continue treatment, including resuscitation, or provide nutrition and hydration by medical intervention, if you judge that the treatment is unlikely to work; or might cause the patient more harm than benefit; or is likely to cause the patient pain, discomfort or distress that will outweigh the benefits it may bring. 


Positions
The Bill has the backing of the likes of Vicky Phelan (who, as a terminally ill woman, wants to be able to say goodbye on her own terms) and Tom Curran, the partner of the late motor neuron sufferer and right-to-die campaigner Marie Fleming. Looking them in the eye it might be difficult to say someone destined for premature death should still be forced to through the uncontrollable distress. But there are others – Peadar Tóibín among them – who believe when pain relief is more sophisticated than ever, the role of governments should be on making life worth living, and who cannot contemplate the idea of ever permitting one person to kill another, even with consent. (Source: Meathchronicle) Another party that is against the bill is the Hope Ireland group: ‘a coalition of medical professionals and disability rights advocates who aim to bring informed perspectives to the debate around euthanasia and assisted suicide in Ireland’. They argue that ‘the introduction of assisted suicide and euthanasia is a regressive step for vulnerable people – particularly the elderly and those with disabilities.’ No professional medical body in Ireland supports the Dying with Dignity Bill which has ‘very few safeguards’ to protect vulnerable people. ‘This Bill normalises suicide at a particularly vulnerable time and will undermine all suicide prevention principles and efforts.’ Quaker mystic Thomas Kelly (1893–1941) wrote: “Eternity is at our hearts, pressing upon our time-torn lives, warming us with intimations of an astounding destiny, calling us home unto Itself. Yielding to these persuasions, gladly committing ourselves in body and soul, utterly and completely, to the Light Within, is the beginning of true life.” (Source: The Mayo News) The bill goes further than other such laws in Europe, pro-life activists are warning. Read more on this point of view on the website of Cruxnow.  

Vicky Phelan
The Irish woman Vicky Phelan, being diagnosed with terminal cancer after having initially been given the all-clear, supports the Dying with Dignity bill but does not want to see it go to Citizens’ Assembly. Phelan told The Irish Independent: “I also don’t think that it is something that should be voted on by a Citizens Assembly since the courts ruled that there is nothing to stop the Oireachtas from legislating to allow for assisted dying as long as the appropriate safeguards are in place. I believe that this bill provides those safeguards.” She added: “I would like to see this Dáil having the balls to deal with this bill and to vote it through to give people like me the option of dying with dignity at home here in Ireland.” During a debate on the bill on Thursday night (the 1st of October), Labour leader Alan Kelly read out a statement from Vicky Phelan: “I do not want to die. I am not choosing between living and dying. My cancer is incurable. The option of living will no longer be available to me in the not too distant future,” the statement said. “I just want to be allowed to have the choice to control the circumstances of my death much as I have made decisions about my own life. Do not kick this issue down the road for another 12 months. Please.” 


DIGNITAS
DIGNITAS – To live with dignity – To die with dignity, our Swiss Member Organisation, has also come out in favour of the Death with Dignity bill. DIGNITAS told The Irish Independent that nine Irish people have traveled to Switzerland to end their lives with the help of the charity between 1998 and 2019. DIGNITAS said it currently has 56 Irish members, though that may include supporters who do not intend to end their own lives with assisted suicide. In a statement on Friday October 2, DIGNITAS said that “the freedom to decide on the time and manner of one’s own end in life is a human right, and suffering Irish people should be allowed the choice of ending their suffering and life in a legal, safe and self-determined manner at home. A rising number of states have legalized assisted dying, and their experiences prove the fear-mongers wrong.” DIGNITAS said that while medicine had helped improve life expectancy, some people did not consider hospice or palliative care to be the right choice for them. It said that the “uncomfortable truth” was that people in Ireland may be trying and failing to end their lives at home. “Hundreds of Irish people take the drastic measure of a ‘do-it-yourself’-suicide, and we must always remember that, as well as the number of deaths by suicide, a much higher number of people attempt suicide but fail: research results show that there are up to 50 times more failed attempts than deaths by suicide, often with dire consequences and more suffering for the individual, their loved ones, and others such as rescue teams,” it said. The group said that those who can travel to Switzerland do so “in the shadow of the fear of being detained, labelled incompetent, and having their loved ones criminalized.” Read also their press release

What’s next?
Although Kenny’s party has only 5 members in the Dáil, other parties have indicated they could support the proposed law, including Sinn Fein, Labour, and the Green Party. At the 7th of October, the Dying With Dignity Bill has passed its first formal vote in the Dáil, by 81 votes to 71.  Before this voting, there was a Government motion which, instead of progressing the Bill to committee stage now, wants to park it for a year to establish a new bespoke committee on the topic. This motion was rejected, just as a new bespoke committee on end-of-life issues (in a vote 86 to 65, with one abstention). 


Sources:
– Irish Central 
– The Mayo News
– The Irish Independent 

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