Assisted Suicide, Euthanasia and the Dying with Dignity Bill 2020

Abstract

Assisted Suicide, Euthanasia and the Dying with Dignity Bill 2020 1 Noreen O’Carroll Introduction Dáil Éireann is currently debating the Dying with Dignity Bill 20202 . Everyone would like to die with dignity. Debating this would therefore appear to be an uncontroversial thing to do. But the bill is of particular concern, because it proposes radical legislative, medical and social change in Ireland by making provision for assisted suicide and euthanasia. ‘Assisted suicide’ refers to cases in which, at the voluntary request of a patient with decision-making capacity, a doctor deliberately enables a patient to end his or her own life by prescribing or providing medical substances with the intent to bring about death. ‘Euthanasia’ refers to a doctor deliberately administering a lethal substance or carrying out an intervention to cause the death of a patient with decision-making capacity at the patient’s own voluntary request.3 The scope of the Dying with Dignity Bill 2020 also provides for a nurse to be involved in these practices, where the patient’s doctor authorises this. The present measure was initiated as a Private Members’ Bill by Gino KennyTDon15September2020.TDsprogresseditquicklyanditcompleted its second stage on 7 October 2020, when a majority voted for it (81 to 71).4 A bill has to progress through five stages in the Dáil and be passed before going to Seanad Éireann, where the process begins again from the second stage. Once the Dáil and Seanad both pass the bill, the Taoiseach presents a copy to the President to sign into law.5 When the bill was introduced in the Dáil, the country was weighed down by Covid-19 and as a result it went unnoticed by most people. One commentator observed that the rush to enact this legislation at a time when the country was so distracted by a once-in-a-century pandemic was an act unworthy of a healthy democracy.6 Should Ireland enact legislation for assisted suicide and euthanasia? Studies • volume 110 • number 438 142 Underlying assumptions Two assumptions underlie the Dying with Dignity Bill 2020. The first is that the final stages of terminal illness rob patients of their dignity as human beings and they should therefore be permitted to choose the means and time of their own death with assistance from a healthcare professional, so as to ‘die with dignity’. It is the case that some patients associate the loss of physical and cognitive abilities as a consequence of their illness with a loss of dignity. However, human dignity cannot be lost through illness or disability, because it is inherent in each person. This is affirmed in the Universal Declaration of Human Rights. Such dignity, ‘the foundation of freedom, justice and peace in the world’, belongs to ‘all members of the human family’. ‘All human beings’, it states, ‘are born free and equal in dignity and rights’.7 A patient’s human dignity, therefore, is not something that can be lost through illness and its effects. Some terminally ill patients do not fully understand this and need to be helped to see that they can die naturally with dignity while receiving the best possible medical and palliative care provided by the healthcare professions. The Dying with Dignity Bill 2020 does not provide for a death with dignity; it only provides for the legal option of a premature death by assisted suicide or euthanasia. The second assumption underlying the bill is that a death by assisted suicide or euthanasia is flawless, painless and quick. This is a common belief, but it is mistaken. No medical procedure is flawless; every medical procedure has complications, problems and associated risks. Assisted suicide and euthanasia are no exceptions.8 An analysis of data from two studies of assisted suicide and euthanasia in the Netherlands based on an examination of 649 cases indicates that technical problems, complications and problems with completion occurred during both procedures. The analysis of 114 cases of assisted suicide indicated that: • Technical problems occurred in 11 cases. In the case of 1 patient, the fluid injected into a vein flowed back out of the vein at the injectionsite.7patientshaddifficultyadministeringtheoraldrug. 3 patients suffered from other problems including inappropriate equipment...