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THIS WEEK THE Dáil will debate a new bill that could legislate for assisted dying in Ireland if it becomes law.
The bill, which has been introduced by People Before Profit TD Gino Kenny, aims to allow citizens to die with medical assistance if they are terminally ill.
The practice is legal in several other countries and already has several high-profile advocates in Ireland, but it is highly controversial and fraught with ethical dilemmas.
Here’s our crash course on what assisted death means, the arguments for and against, and what the proposed legislation entails.
What is assisted death?
As the term suggests, assisted death is the act of deliberately providing medical assistance to another person who wishes to end their own life.
For example, if a friend or family member of someone helps them acquire drugs knowing that they intend to use those drugs to commit suicide, they would be participating in the act of assisted death.
The practice differs from euthanasia, which is what happens when a second party intentionally ends someone’s life to alleviate their suffering, such as a doctor administering a lethal injection to someone who is terminally ill.
Helping someone take their own life is currently illegal under Irish law, while taking their own life is not.
Under Section 2 of the Criminal Law (Suicide) Act 1993, any person who “assists, incites, advises or causes the suicide of another [person]”He can be convicted and imprisoned for up to 14 years.
Last year, an Amárach / Claire Byrne Live poll for TheJournal.ie found that 55% of people think that assisted suicide should be legal in Ireland, with 22% of people against.
Why is it on the news?
A new bill that would legalize assisted dying, the 2020 Dying with Dignity Bill, will be brought before the Dáil after its launch earlier this month.
The issue has already made headlines in recent years through the cases of Marie Fleming (who lost a Supreme Court appeal to establish a constitutional right to die) and Gail O’Rorke (who was tried on charges that tried to help her mother’s suicide). friend).
Marie Fleming, an assisted dying activist who died seven years ago
Source: Sam Boal / RollingNews.ie
Although the bill was initially expected to be rejected by the government, there is now a real chance that it could move forward after coalition parties signaled last week that a conscience vote could take place.
This is where TDs can vote on an issue according to their own personal conscience, rather than having to vote on an official line set by their party.
Fine Gael MPs and senators made speeches in favor of the vote of conscience at a party meeting last Wednesday, before Green Party leader Eamon Ryan suggested he would allow a vote of conscience on the proposed legislation Thursday. .
For Friday, Taoiseach Micheál Martin also indicated the possibility of a vote of conscience among the TDs of Fianna Fáil, saying that it was the party’s recent policy to vote on questions of life and death.
What does the Dying with Dignity bill include?
According to its explanatory memorandum, the aim of the bill is “to provide assistance to achieve a dignified and peaceful end of life” for those who wish to die, particularly those suffering from a terminal illness.
It consists of 15 sections, which establish who could request help to die, the criteria under which they could do so, and the rules on the role of those who would give them medical help.
Under the terms of the bill, a person can only apply for dying assistance if they have a terminal illness, defined as one that is “incurable, progressive, and … that cannot be reversed with treatment.” This disease must be verified by two doctors.
The person must also be over 18 years of age and resident in Ireland for at least one year.
Fundamentally, a person who says they want assistance to end their own life must have the capacity to do so, something that would also be evaluated by doctors.
If a person meets these criteria and then wishes to end his own life, he must state his clear intention to do so and sign a statement in the presence of a witness, which must also be signed by two doctors.
None of these practitioners were able to act as a witness for the person. In other words, the declaration must be signed by four people.
Source: Oireachtas.ie
Two weeks after the declaration takes effect, a doctor will prescribe substances so that the person can end their own life.
A doctor or his assistant (that is, a nurse) could provide the person with these substances and help him administer them and would have to stay with him until he took them or chose not to take them.
At all times, doctors would have to keep records, including a final statement that assisted death has occurred, no more than a week after the administration of the substance.
Safeguards
Given the moral considerations involved throughout the process, the bill also contains safeguards to ensure that a person is qualified to make the decision to end their own life.
The bill does not only contain criteria for the person who is going to die: there are provisions for conscientious objection for doctors who are morally against assisting in the death of a patient.
If the bill becomes law, the roles of two doctors, one of whom would have to be independent, would be central to the entire process.
The independent physician could not be a relative, partner, or colleague of the first physician (who would likely be the person’s physician).
At various stages, these professionals would be trusted to ensure that everything from the person’s medical condition to the transparency of their decision to end their own life is correct.
In the first stage, the two doctors would also have to verify the person’s terminal illness and assess their ability to make the decision to end their own life.
Those who cannot understand or retain end-of-life information, or those who cannot communicate their decision to do so, will not be able to request assistance.
So someone in a coma, for example, could not be considered capable of seeking medical help to end their own life if the bill becomes law.
Eamon Ryan has indicated that he could allow a vote of conscience on the issue among green TDs.
Source: Sam Boal / RollingNews.ie
Meanwhile, there would also be certain criteria around the person’s statement.
In addition to the two doctors, the statement would have to be signed by a witness, whom the bill specifically states must sign it in the presence of the person who wishes to die.
This witness would also have to be someone who would not benefit from the person’s estate after their death.
Any of the four people who would sign the statement could later revoke their signature, and they would not have to do so in writing.
Both doctors would also need to be satisfied that the person seeking to die is fully informed about the palliative, hospital, and other care available to them.
The person would have to wait 14 days after the statement was activated, the date the independent physician signs it, before they could end their own life.
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However, this would be reduced to six days if both doctors believed that a person’s death from terminal illness could occur within a month from the day the declaration takes effect.
Finally, any substance that would be supplied to the person wishing to die could only be delivered after a treating physician confirmed that the person had not revoked and did not wish to revoke their statement.
If the person decided not to take the substance, the doctor would have to remove it immediately.
What do advocates of assisted dying say?
Most of the arguments in favor of assisted dying are ethical or practical considerations that focus on compassion and personal freedom.
From an ethical point of view, some advocates say that people should be able to choose how and when to end their own lives under the principle of free choice.
They say this is particularly true when a person wants to reduce their suffering due to a terminal illness, but cannot do so in a palliative setting or without facing additional suffering.
Some argue that those who are going to die anyway should be allowed to avoid the pain and anxiety that sometimes occurs in the final months of terminal illness.
Where assisted dying is available, it is argued that a person may have a more peaceful and dignified death than if they chose to end their own life outside of a medical setting.
Others also suggest that many practices used in end-of-life care, such as palliative sedation (where a person is sedated with non-lethal medications to alleviate their suffering) is a form of assisted death, particularly as some sedatives can shorten the time. of life. lifespan of the person.
What are the arguments against assisted death?
As the safeguard criteria in the proposed legislation show, assisted dying is an extremely complicated process and there are concerns that it may be open to abuse.
There is concern that the introduction of the procedure could be a slippery slope and that it could shift from those who are terminally ill to other parts of the population, such as people with disabilities.
There is a fear that vulnerable people may be forced to agree to end their own lives, or that assessments of a person’s ability to decide may fail.
Meanwhile, some have doubts about whether assisted dying is a solution to suffering in a society that offers palliative care, where people can die in a dignified and painless way.
There is another argument that asks if more investment is required in this type of treatment, instead of legislating for a much more complicated process.
Ethical considerations also play a role, as they do among advocates of assisted dying.
Many wonder if helping a person end their own life is more moral than murder, while others have wondered if the practice is compatible with medical ethics and the role of doctors to heal, rather than harm, whom they treat.
What happens next?
The Dying with Dignity bill will be debated in the Dáil on Thursday, before TDs vote on whether it should move to committee stage for further oversight next week.
Sinn Féin, Labor, Social Democrats and People Before Profit have said they will vote for the bill next week, but there are some independent TDs who will not.
The three governing parties will likely confirm whether they will allow a free vote on the proposed legislation before Thursday’s debate, which could indicate how likely the possibility of assisted death is in the coming years.
In the meantime, you can read the full invoice here.
If you need to speak, assistance is available:
- Samaritans 116123 or email [email protected]
- Conscious 1800 80 48 48 (depression, anxiety)
- Pieta House 1800 247 247 or email [email protected] (suicide, self harm)
- Teen-Line Ireland 1800833634 (for ages 13-19)
- Childline 1800 66 66 66 (for those under 18 years of age)
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