In the teeth of a process where it became clear that the majority of doctors in Ireland, groups representing people with disabilities, and anti-suicide advocates oppose the legalisation regarding assisted dying, the joint Oireachtas committee still recommended proceeding.
Does this remind you of recent events involving politicians ploughing ahead in happy obliviousness to dissenting voices? Alan Farrell TD said it was “untenable” for committee chairman Michael Healy-Rae to support a minority report by Senator Rónán Mullen and Robert Troy TD. What was Healy-Rae supposed to do? Set aside his conscience and side obediently with the majority? There are 38 recommendations in the majority report, obviously designed to forestall objections by making access to euthanasia appear as restrictive as possible.
This illustrates perfectly the myth of Irish exceptionalism: that due to our extraordinary qualities, we will manage to maintain restrictions that other lesser countries have not. Belgium, the Netherlands and Canada have seen expansion after expansion of the grounds for assisted suicide and euthanasia. Yet we retain the fond delusion that there is something about the Irish that means we will not slither down any slippery slopes because, well, we are Irish.
The figures from the Netherlands from 2022 make for shocking reading. Euthanasia accounted for over one in 20 of all deaths in the Netherlands that year, a 13.6% increase from the previous year
We maintain this belief stubbornly in the face of the fact that in many areas, from statements of salaries of RTÉ presenters to taking down terrorist content from the internet, we manage to ignore regulations blithely.
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The figures from the Netherlands from 2022 make for shocking reading. Euthanasia accounted for over one in 20 of all deaths in the Netherlands that year, a 13.6 per cent increase from the previous year, according to the regional euthanasia review committees. This figure has been increasing steadily.
Data compiled by the committees found that 288 people were euthanised on grounds of dementia, six of whom were deemed not competent to decide but had made their wishes known in advance, and 115 people were granted it on the grounds of psychiatric disorders.
Committee members in favour of assisted dying will note that their recommendations explicitly rule out advance directives being used when a person is no longer competent.
My point is that this is naive. Would the Dutch have ever introduced euthanasia if they had known that the concept of unbearable suffering would one day expand to people with depression and even to babies with spina bifida?
The majority report also stresses that coercion will be a criminal offence. What about internal coercion, the feelings of guilt at being old, incapacitated or potentially a burden?
Assisted dying and euthanasia irrevocably change the entire medical and cultural landscape into which they are introduced.
Joseph P Overton, a free-market libertarian, used a cardboard slider like a small window to demonstrate the concept of what was politically possible. Everything within the window is normal and acceptable — everything outside is radical and unthinkable. Overton showed how the window can be shifted. Once assisted dying is legalised, the Overton window is shifted forever.
The majority report also stresses that coercion will be a criminal offence. What about internal coercion, the feelings of guilt at being old, incapacitated or potentially a burden?
Once assisted dying becomes one of a menu of options, some people will opt to die rather than live believing that they are burdensome to someone else.
Many Irish doctors are either conflicted about or actively oppose assisted dying. For example, the Royal College of Physicians of Ireland is our largest postgraduate medical training body and a professional organisation for medical doctors, with more than 11,000 members and fellows across 29 different medical specialities in more than 90 countries. It opposes assisted dying because it is against the best medical practice, it is impossible to implement safeguards and could potentially undermine the excellent Irish palliative care system.
Dr Regina McQuillan, representing the Irish Palliative Medicines Consultants Association, which cares for 28,000 patients and their families annually, said the introduction of assisted dying would significantly and negatively affect the trusted relationship that exists between doctors and patients. The majority report believes it knows better than palliative medicine consultants.
Society must promote hope. Assisted suicide is a statement of no hope … We can all help to fight against suicide by turning our back on assisted suicide
— Elma Walsh
The minority report cites an important statement by Peter Kearns, of the Independent Living Movement of Ireland. He said that people with disabilities feel that the priority should be to legislate for the right to live independently, rather than assisted suicide.
The anger of people with disabilities was part of the reason for the landslide defeat of the so-called Care Amendment. It appears the referendum wording was carefully framed to avoid governmental liability. People want a health system that works, an end to people spending 72 hours on trolleys and a million people on waiting lists.
Assisted suicide kills hope. Elma Walsh, mother of Donal, who before his death from cancer spent so much time combating suicide, made this point eloquently. “Society must promote hope. Assisted suicide is a statement of no hope,” she said. “We can all help to fight against suicide by turning our back on assisted suicide.”
It is not Michael Healy-Rae’s support of the minority report which is untenable. It is the idea that there is any big public clamour for something that has proven difficult to prevent from expanding like a deadly pathogen in other European countries.