- The Future of Regulation of Euthanasia and Physician-Assisted-Suicide in Ireland
Preservation of the current law, as it stands, is one course for the future of Ireland. Equally, to allow for some form of assisted dying, legislation can be enacted.
In 2015, Deputy John Halligan proposed The Right to Die with Dignity Bill. The legislation sought to enable qualified persons to get assistance in attaining a dignified and peaceful end of life. Deputy Halligan, furthermore, reiterated that the proposal was meant to aid people who, at their most distressing times, were being deprived of their human rights (Gillet, 2015). Basing on the provision of the Bill, two separate and qualified medical practitioners would examine an eligible patient. After that, they will indicate on a declaration form that the assessed patient has a progressive ailment that cannot be reversed by available medical treatment and would likely lead to the death of the person. Moreover, a third independent witness, who is not bound to benefit from the patient’s estate, will testify that the patient has resolved to terminate their life if it becomes unbearable (Humanitarian Association of Ireland, 2015). Before termination, nonetheless, it must be proven, by a medical practitioner, that the person seeking to terminate their life is mentally sound.
Additionally, their decision should be based on informed consent and without duress ( Joint Committee on Justice and Equality (2018), pp. 18-19). Notably, doctors with conscientious objection will not be obliged to participate in assisting patients to commit suicide. Doubtlessly, enacting such legislation will tremendously empower people, who are unable to bear with suffering, to attain dignified death.
The European Court of Human Rights (ECHR), in cases like Koch v Germany ((2012) Application number 497/09), recognized that the applicant, who was a widower of a patient who had sought euthanasia, was directly affected by Germany’s refusal to grant the deceased authorization to acquire lethal dose. The court observed that, under Article 8 of the European Convention of Human Rights, the applicant’s procedural right to privacy had been violated. Also, the court recognized that every European country had an obligation to take measures to facilitate dignity in death (Koch, para. [48]).
In the Pretty v United Kingdom case of 2002 (Application number 2346/02), the European court observed that Article 2, which guaranteed the right to life, did not confer any diametrically opposite right- the right to die (Pretty, para. [52]). Nonetheless, in the Haas v Switzerland case of 2011 (Application number 31322/07), the court granted the applicant euthanasia and assisted suicide. Here, the court considered Article’s 8 “Right to Privacy”. According to the court, the article provided for the right to suicide; every person was legally allowed to determine when and how their life ended (Haas, para. [51]). The Haas judgment notwithstanding, ECHR still maintained that any European country was free to focus more on the preservation of the life of a person rather than to end it. In essence, the ECHR noted that those countries opposed to euthanasia were at liberty to do so.
The ECHR also reckon that the right to suicide is conditional; any person seeking to terminate life must be able to come to such a conclusion and act accordingly freely. This means that every individual should meet a practical condition for the acceptance of assisted suicide. Irrefutably, the three cases mentioned above will inform a future review of cases in Ireland.
Another noteworthy inquiry is that of Gail O’Rorke v Ireland of 2014. O’Rorke was arrested and later charged, under the Criminal Law Act of 1993, with aiding in the suicide of her friend Bernadette Forde. In April 2015, Judge McCartan ruled that ordering barbiturates from Mexico, and booking flight tickets, were not enough evidence for a conviction. While this case, on its own, will have restricted place in the promotion of euthanasia in Ireland, it might guide similar cases and convictions in the future.
In November 2017, The Palliative Care Service Three-Year Development Framework 2017-2019 was launched. This was upon the advice of palliative care workers in Ireland. These workers argued that accessible and functional palliative care could tremendously reduce the demand for assisted dying (Joint Commission on Justice and Equality, (2018) pp.20-21). Notable aspects of the framework included;
a). Access to palliative care facilities for every patient, not just cancer patients.
b). Admission into these facilities regardless of disease severity.
c). Addressing provincial disparities in providing palliative care.
In the framework, it was projected that by 2031, the number of persons over sixty-five years of age would have increased by more than four hundred thousand. Also, in the same time frame, the number of deaths would multiply by ten thousand. The deaths would be accompanied by a rise in cases of neurodegenerative diseases, cancers; two conditions that increase the demand for palliative care and euthanasia for the patients who will be unable to bear the pain (ibid, pp. 21-22). Full implementation of this framework will likely derail the crusade of the proponents of euthanasia and assisted suicide. This is because, if palliative care is proved to decrease the demand for euthanasia, then the State, which is already reluctant to grant its citizens assisted suicide, will highly likely settle for the former.
In 2017, the Oireachtas Joint Committee on Health and Children sought to suggest possible recommendations in support of assisted suicide and euthanasia. However, upon reaching a stalemate, the joint committee convinced the Houses of the Oireachtas to let the Citizens Assembly deliberate on the issue. Whele the committee did not achieve a clear consensus, there were valuable views from the opponents of euthanasia. Dr. McQuillan noted that one untoward effect of acceptance of assisted suicide would be under-investment in palliative care and service delivery. This is because most families will see euthanasia as a cheaper alternative to palliative care. Additionally, legalizing assisted suicide may put pressure on the emotionally labile people, who might end up hastening death to circumvent the sense of being a burden to people (McQuillan, (2017), pp.1-2). As a rebuttal, she also emphasized that decriminalization of suicide was the government’s way of acknowledging that survivors of attempted suicide needed psychiatric help, not prosecution. Furthermore, Dr. McQuillan echoed the World Medical Association’s long-standing opposition to the hot-button issue. She stated that physician-assisted suicide constituted the unethical practice of medicine. Critically looking at Dr. McQuillan’s argument, it seems justifiable to assert that medical practitioners’ objection to euthanasia and assisted suicide will upset progress towards legalization of the practice in Ireland. Nonetheless, with the Joint Committee referring this issue to the Citizens Assembly, it seems possible that the people’s voice will triumph, and that euthanasia will be introduced on some limited ground, for example, to the terminally ill patients. But with time, and with an expanding horizon of eligibility, the practice will be more liberal and widely accepted. Thus, the Oireachtas Joint Committee’s decision to refer the issue to the Citizens Assembly can possibly lead to the introduction of assisted suicide in the country.
Conclusion
To sum up, the current State of affairs ought to be amended. There should be provisions in the Irish Laws that give considerations, on a case-by-case basis, to people seeking euthanasia. However, strict requirements should first be met before one is eligible for assisted suicide. Irrefutably, failure to consider the wishes of patients with progressive and untreatable diseases or chronic pain is violating fundamental human rights. Also, it denies these people the dignity they deserve in death.
Article
Gillett, G., 2015. Assisted dying Bill to prompt debate on the right to die. BMJ, 351, p.h4389. doi: https://doi.org/10.1136/sbmj.h4389
Humanist Association of Ireland, 2015. Dying With Dignity Bill Passes First Stage In Dail – Humanist Association Of Ireland. [online] Humanist Association of Ireland. Available at: https://www.humanism.ie/2015/12/dying-with-diginity-bill-passes-first-stage-in-dail[Accessed 16 April 2020].
Report
Joint Committee on Justice and Equality (Ireland) (2018) Report on the Right to Die With Dignity Bill (Dublin). Available at: https://data.oireachtas.ie/ie/oireachtas/committee/dail/32/joint_committee_on_justice_and_equality/reports/2018/2018-06-25_report-on-the-right-to-die-with-dignity_en.pdf [Accessed 16 April 2020].
McCarthy, J., 2014. End-of-life care in Ireland: ethical challenges and solutions. Opening Statement to the Houses of the Oireachtas Joint Committee on Health and Children, 24 October 2013.