3. The Bill ignores the evidence that vulnerable people will be pressured to end their lives
The Bill makes almost no effort to include safeguards for vulnerable people. It is now well established from the experience of other countries that vulnerable people feel under pressure to die by Assisted Suicide. Some 56% of people who died by assisted suicide said that being a burden on family, friends and caregivers was a reason to end their lives, according to a 2017 study in Washington State.
4. Conscience rights are not protected
Doctors would be obliged to refer patients for assisted suicide, striking down their right to conscientious objection.
EIGHT REASONS TO OPPOSE ASSISTED SUICIDE
1. Doctors have urged legislators not to legalise Assisted Suicide - and to support palliative care
The Irish Palliative Medicine Consultants’ Association (IPMCA) are the medical experts who focus on managing and relieving pain, especially at end-of-life. The IPMCA wrote to TDs in 2020 saying, with palliative care, even severe physical or psychological distress can be managed.
They say they are “opposed to any form of legislation for assisted dying, assisted suicide or euthanasia in Ireland” and that “compassion, advocacy and support are at the heart of the palliative care that is delivered across Ireland to those who are suffering as a result of advanced illness”. They also say that “intended and inevitable unintended consequences of the proposed legislation are stark and unthinkable”.
The Royal College of Physicians of Ireland (RCPI) says advances in medicine and in palliative care mean that “nobody should be suffering either mentally or physically”, and that “in the worst cases, palliative sedation [is] available to address intractable physical pain”.
It opposes assisted suicide “because it is contrary to best medical practice” and prefers “a considered and compassionate approach to caring for, and proactively meeting the needs and concerns of patients who may be approaching the end of their life”.
The RCPI is also concerned that a move towards assisted suicide would result in a shift in focus away from the development and the delivery of palliative care services and cure, and that research into palliative care may be discouraged.
A 2020 survey by the IPMCA showed that 88% of palliative medicine doctors are opposed to assisted suicide. In Britain, a 2019 survey found that 84% of doctors there felt the same. The Royal College of Physicians in Ireland says assisted suicide “is contrary to best medical practice”
The view of the leading medical experts caring for terminally ill and elderly patients could be summarised in the words of Prof Tony O’Brien who told the High Court in the Fleming case that doctors should not seek to “kill pain by killing patients”.
2. The number of people ending their lives increases rapidly once the law changes.
In Canada, the number of people availing of assisted suicide has increased fivefold in just four years since 2015. In Belgium, euthanasia cases have increased by a factor of ten since 2003, while the Netherlands has seen an almost five-fold increase in deaths since 2002.
These rapidly increasing rates of deaths from Assisted Suicide should give even the most ideological campaigner pause.
Belgium has allowed children to be euthanised since 2014, and the euthanasia of children is also now permitted in the Netherlands.
3. The number of other suicides also increases - by 34% in the Netherlands
Does assisted suicide seriously undermine the anti-suicide messages society has worked so hard to build?
Professor Theo Boer, a leading Dutch expert who sat on euthanasia review panels for almost a decade, has shown that after euthanasia was legalised in the Netherlands the number of other suicides went up - with a rise of almost 34% in less than a decade. “In surrounding countries, most of which have no assisted dying practice, the suicide numbers went down.
The Bill makes almost no effort to include safeguards for vulnerable people. It is now well established from the experience of other countries that vulnerable people feel under pressure to die by Assisted Suicide. Some 56% of people who died by assisted suicide said that being a burden on family, friends and caregivers was a reason to end their lives, according to a 2017 study in Washington State.
4. Conscience rights are not protected
Doctors would be obliged to refer patients for assisted suicide, striking down their right to conscientious objection.
EIGHT REASONS TO OPPOSE ASSISTED SUICIDE
1. Doctors have urged legislators not to legalise Assisted Suicide - and to support palliative care
The Irish Palliative Medicine Consultants’ Association (IPMCA) are the medical experts who focus on managing and relieving pain, especially at end-of-life. The IPMCA wrote to TDs in 2020 saying, with palliative care, even severe physical or psychological distress can be managed.
They say they are “opposed to any form of legislation for assisted dying, assisted suicide or euthanasia in Ireland” and that “compassion, advocacy and support are at the heart of the palliative care that is delivered across Ireland to those who are suffering as a result of advanced illness”. They also say that “intended and inevitable unintended consequences of the proposed legislation are stark and unthinkable”.
The Royal College of Physicians of Ireland (RCPI) says advances in medicine and in palliative care mean that “nobody should be suffering either mentally or physically”, and that “in the worst cases, palliative sedation [is] available to address intractable physical pain”.
It opposes assisted suicide “because it is contrary to best medical practice” and prefers “a considered and compassionate approach to caring for, and proactively meeting the needs and concerns of patients who may be approaching the end of their life”.
The RCPI is also concerned that a move towards assisted suicide would result in a shift in focus away from the development and the delivery of palliative care services and cure, and that research into palliative care may be discouraged.
A 2020 survey by the IPMCA showed that 88% of palliative medicine doctors are opposed to assisted suicide. In Britain, a 2019 survey found that 84% of doctors there felt the same. The Royal College of Physicians in Ireland says assisted suicide “is contrary to best medical practice”
The view of the leading medical experts caring for terminally ill and elderly patients could be summarised in the words of Prof Tony O’Brien who told the High Court in the Fleming case that doctors should not seek to “kill pain by killing patients”.
2. The number of people ending their lives increases rapidly once the law changes.
In Canada, the number of people availing of assisted suicide has increased fivefold in just four years since 2015. In Belgium, euthanasia cases have increased by a factor of ten since 2003, while the Netherlands has seen an almost five-fold increase in deaths since 2002.
These rapidly increasing rates of deaths from Assisted Suicide should give even the most ideological campaigner pause.
Belgium has allowed children to be euthanised since 2014, and the euthanasia of children is also now permitted in the Netherlands.
3. The number of other suicides also increases - by 34% in the Netherlands
Does assisted suicide seriously undermine the anti-suicide messages society has worked so hard to build?
Professor Theo Boer, a leading Dutch expert who sat on euthanasia review panels for almost a decade, has shown that after euthanasia was legalised in the Netherlands the number of other suicides went up - with a rise of almost 34% in less than a decade. “In surrounding countries, most of which have no assisted dying practice, the suicide numbers went down.
Germany, with a population much like the Dutch in terms of age, economy, and religion, saw its suicide numbers decrease by 10 percent in the same period,” he wrote.
It had been claimed that legalising assisted suicide would reduce the number of total suicides, but research contrasting the experiences of states in the U.S., found that legalizing assisted suicide “has been associated with an increased rate of total suicides” and “no decrease in non-assisted suicides”.
4. Vulnerable people can feel pressured to end their lives
Some 56% of people who were killed by assisted dying said being a burden on family, friends and caregivers was a reason to end their lives, according to a 2017 study in Washington State - with 54% saying the same in Oregon in 2018. In the Netherlands, it has been estimated that 1 in 5 patients who sought euthanasia came under pressure to end their lives.
Please see some of the disturbing cases that have already arisen where vulnerable people have been pressured to die by Assisted Suicide below.
A recent survey by the Dutch medics’ federation KNMG also found that 70% of doctors had felt under pressure to grant euthanasia.
5. Assisted Suicide is also strongly opposed by disability groups Disability groups are some of the strongest voices against assisted suicide. As activist Mark Davis Pickup who has MS says, his healthy neighbours will get suicide prevention while he’ll be offered assisted suicide. The Royal College of Physicians notes: “All major UK advocacy groups for disability have rejected assisted suicide.”
The American Association of People with Disabilities says assisted suicide laws also give “insurance companies and physicians new rights too – the legal means to deny treatment”. In Canada, a UN disabilities advocate reported in 2019 that she had “received worrisome claims about persons with disabilities in institutions being pressured to seek medical assistance in dying, and practitioners not formally reporting cases involving persons with disabilities.”
“Suicide is not seen as socially desirable, so why is assisted suicide seen as compassionate when it’s for ill or disabled people?" says Liz Carr, a disability activist and actress
6. The Irish Courts have ruled that safeguards are impossible
The High Court in the Fleming case ruled that: “even with the most rigorous systems of legislative checks and safeguards, it would be impossible to ensure that the aged, the disabled, the poor, the unwanted, the rejected, the lonely, the impulsive, the financially compromised and emotionally vulnerable would not avail of this option to avoid a sense of being a burden to their family and society.”
The Supreme Court, on appeal in 2013, warned of the difficulty in changing the law “without jeopardising an essential fabric of the legal system – namely respect for human life and compromising these protections for others”.
7. Assisted Suicide can be seen as a means of cutting healthcare costs
While campaigners insist this is about choice, in reality, insurance companies, budget committees and others are looking at cost savings. After Assisted Suicide was legalised in Canada, a paper published in a leading medical journal, The Canadian Medical Association Journal, claimed that millions of dollars could be saved in health care spending by ‘assisting’ people to die. It “could result in substantial savings”, the paper noted approvingly.
A Canadian budget report said $149 million could be "saved" on the annual cost of end-of-life care by assisted suicide. This is a very disturbing trend, particularly in light of ageing populations and increased pressures on healthcare budgets.
Dr Brian Callister, a physician practising in Nevada, spoke out ton he danger for people who were sick and vulnerable.
"I had two patients recently in Nevada on my service; both needed life-saving procedures - not palliative care, not hospice, these would have been curative procedures," he stated. "One patient was from California which has passed assisted suicide and one patient was from Oregon which has had it for 20 years.
It had been claimed that legalising assisted suicide would reduce the number of total suicides, but research contrasting the experiences of states in the U.S., found that legalizing assisted suicide “has been associated with an increased rate of total suicides” and “no decrease in non-assisted suicides”.
4. Vulnerable people can feel pressured to end their lives
Some 56% of people who were killed by assisted dying said being a burden on family, friends and caregivers was a reason to end their lives, according to a 2017 study in Washington State - with 54% saying the same in Oregon in 2018. In the Netherlands, it has been estimated that 1 in 5 patients who sought euthanasia came under pressure to end their lives.
Please see some of the disturbing cases that have already arisen where vulnerable people have been pressured to die by Assisted Suicide below.
A recent survey by the Dutch medics’ federation KNMG also found that 70% of doctors had felt under pressure to grant euthanasia.
5. Assisted Suicide is also strongly opposed by disability groups Disability groups are some of the strongest voices against assisted suicide. As activist Mark Davis Pickup who has MS says, his healthy neighbours will get suicide prevention while he’ll be offered assisted suicide. The Royal College of Physicians notes: “All major UK advocacy groups for disability have rejected assisted suicide.”
The American Association of People with Disabilities says assisted suicide laws also give “insurance companies and physicians new rights too – the legal means to deny treatment”. In Canada, a UN disabilities advocate reported in 2019 that she had “received worrisome claims about persons with disabilities in institutions being pressured to seek medical assistance in dying, and practitioners not formally reporting cases involving persons with disabilities.”
“Suicide is not seen as socially desirable, so why is assisted suicide seen as compassionate when it’s for ill or disabled people?" says Liz Carr, a disability activist and actress
6. The Irish Courts have ruled that safeguards are impossible
The High Court in the Fleming case ruled that: “even with the most rigorous systems of legislative checks and safeguards, it would be impossible to ensure that the aged, the disabled, the poor, the unwanted, the rejected, the lonely, the impulsive, the financially compromised and emotionally vulnerable would not avail of this option to avoid a sense of being a burden to their family and society.”
The Supreme Court, on appeal in 2013, warned of the difficulty in changing the law “without jeopardising an essential fabric of the legal system – namely respect for human life and compromising these protections for others”.
7. Assisted Suicide can be seen as a means of cutting healthcare costs
While campaigners insist this is about choice, in reality, insurance companies, budget committees and others are looking at cost savings. After Assisted Suicide was legalised in Canada, a paper published in a leading medical journal, The Canadian Medical Association Journal, claimed that millions of dollars could be saved in health care spending by ‘assisting’ people to die. It “could result in substantial savings”, the paper noted approvingly.
A Canadian budget report said $149 million could be "saved" on the annual cost of end-of-life care by assisted suicide. This is a very disturbing trend, particularly in light of ageing populations and increased pressures on healthcare budgets.
Dr Brian Callister, a physician practising in Nevada, spoke out ton he danger for people who were sick and vulnerable.
"I had two patients recently in Nevada on my service; both needed life-saving procedures - not palliative care, not hospice, these would have been curative procedures," he stated. "One patient was from California which has passed assisted suicide and one patient was from Oregon which has had it for 20 years.
In both cases when I was explaining the need for transfer for a life-saving treatment to the insurance medical director in both of those states assisted suicide was offered up instead.”
He says: "The disabled, the depressed, the poor and the marginalized are being forced down this road because they're going to be denied treatment by insurance companies. It's a travesty of social justice."
The next section presents some of the cases that have come to light which indicate that insurance companies and other agents see Assisted Suicide as a preferable alternative to continued care.
8. Disturbing Cases have come to Light
CALIFORNIA One week after California legalised Assisted Suicide in 2016, Stephanie Packer, who was fighting terminal cancer, received a disturbing letter from her health insurance company. Stephanie was told that the chemotherapy treatment the insurance company had previously promised was now being denied. However, she was later informed that her plan would cover the cost of pills for assisted suicide — which would come to just $1.20. For Ms Packer, the reality of how insurers were thinking really "hit her in the gut. “The most cost-effective solution was now assisted suicide," she told Columbia magazine.
OREGON Barbara Wagner, in Oregon, was seeking chemotherapy treatment to fight her advanced lung cancer. ABC News reported that The Oregon Health Plan office refused to pay $4,000 per month because it wasn’t within its narrow guidelines of appropriate treatment. But it did offer to pay $50 for lethal prescription drugs to end her life. Wagner told the local newspaper: 7 “To say to someone, ‘we’ll pay for you to die, but not pay for you to live,’ it’s cruel.”
ONTARIO In 2018, Roger Foley from Ontario, who suffers from an incurable neurological disease, made audio recordings of hospital staff offering him medically assisted death, although he had repeatedly asked for assistance to live at home. A disability envoy from the United Nations raised concerns that patients were being pressured to undergo medically assisted deaths.
ST ANTHONY Canada Candice Lewis suffered from a variety of medical conditions, including spina bifida and cerebral palsy. At her local hospital in Canada in November 2016, the doctor pulled her mother, Sheila Elson, aside to offer assisted suicide for Candice. When Sheila refused, the doctor told her she was being selfish, even though Candice had expressed no wish to die, nor requested assisted suicide.
BELGIUM In Belgium, Tine Nys, a 38-year-old Belgian woman was euthanised on grounds of ‘unbearable suffering’. Her sisters are adamant she was not terminally ill, as Belgian law requires, but suffering from the stress of a broken relationship, and had not, in fact, undergone psychiatric treatment for 15 years.
THE NETHERLANDS In the Netherlands a woman living with dementia had expressed a wish to be euthanised, but also said that she wanted to determine the right time. As her dementia progressed, doctors made the decision for her. A sedative was put in her coffee, but she then woke up and began to struggle. Doctors asked her family to hold her down as they gave the woman the lethal injection. A Dutch court found that they had acted within the law. Thanks
He says: "The disabled, the depressed, the poor and the marginalized are being forced down this road because they're going to be denied treatment by insurance companies. It's a travesty of social justice."
The next section presents some of the cases that have come to light which indicate that insurance companies and other agents see Assisted Suicide as a preferable alternative to continued care.
8. Disturbing Cases have come to Light
CALIFORNIA One week after California legalised Assisted Suicide in 2016, Stephanie Packer, who was fighting terminal cancer, received a disturbing letter from her health insurance company. Stephanie was told that the chemotherapy treatment the insurance company had previously promised was now being denied. However, she was later informed that her plan would cover the cost of pills for assisted suicide — which would come to just $1.20. For Ms Packer, the reality of how insurers were thinking really "hit her in the gut. “The most cost-effective solution was now assisted suicide," she told Columbia magazine.
OREGON Barbara Wagner, in Oregon, was seeking chemotherapy treatment to fight her advanced lung cancer. ABC News reported that The Oregon Health Plan office refused to pay $4,000 per month because it wasn’t within its narrow guidelines of appropriate treatment. But it did offer to pay $50 for lethal prescription drugs to end her life. Wagner told the local newspaper: 7 “To say to someone, ‘we’ll pay for you to die, but not pay for you to live,’ it’s cruel.”
ONTARIO In 2018, Roger Foley from Ontario, who suffers from an incurable neurological disease, made audio recordings of hospital staff offering him medically assisted death, although he had repeatedly asked for assistance to live at home. A disability envoy from the United Nations raised concerns that patients were being pressured to undergo medically assisted deaths.
ST ANTHONY Canada Candice Lewis suffered from a variety of medical conditions, including spina bifida and cerebral palsy. At her local hospital in Canada in November 2016, the doctor pulled her mother, Sheila Elson, aside to offer assisted suicide for Candice. When Sheila refused, the doctor told her she was being selfish, even though Candice had expressed no wish to die, nor requested assisted suicide.
BELGIUM In Belgium, Tine Nys, a 38-year-old Belgian woman was euthanised on grounds of ‘unbearable suffering’. Her sisters are adamant she was not terminally ill, as Belgian law requires, but suffering from the stress of a broken relationship, and had not, in fact, undergone psychiatric treatment for 15 years.
THE NETHERLANDS In the Netherlands a woman living with dementia had expressed a wish to be euthanised, but also said that she wanted to determine the right time. As her dementia progressed, doctors made the decision for her. A sedative was put in her coffee, but she then woke up and began to struggle. Doctors asked her family to hold her down as they gave the woman the lethal injection. A Dutch court found that they had acted within the law. Thanks
Starting with Aquinas can be daunting, here is some help.
https://www.catholicarena.com/latest/aquinas
https://www.catholicarena.com/latest/aquinas
Catholic Arena
Where to Start with St. Thomas Aquinas — Catholic Arena
A short introduction to Aquinas.
Friday 29th January 12pm marks the last opportunity to make submissions regarding Ireland's Euthanasia Bill.
You can do so by emailing [email protected]
Here is a sample analysis that you can use if you wish, published on our website and written by Dr. Kevin Hay.
***
This article examines An Bille um Bás Dínitiúil, 2020 to see what is being proposed for Ireland (and what was omitted) from a medical point of view.
This Bill legalizes Assisted Suicide and Voluntary Euthanasia [AS/VE] for terminal illnesses. Assisted Suicide is defined as the “…prescription of substance or substances which can be orally ingested by the person; (b) in the case of a person for whom it is impossible or inappropriate to ingest orally that substance or substances, by prescribing and providing means of self administration of that substance or substances.” [11.2.A/11.2.B] Assisted Suicide is the prime method to be used and Voluntary Euthanasia is allowed if “…it is not possible for the self-administer then the substance or substances may be administered.” [11.2.C]
In Canada AS and VE are both legal and optional. The vast majority of Canadian recipients choose the Voluntary Euthanasia and few withdraw once approved. Curiously, in Oregon—where AS is the only legal option—about 30% never fill the prescription or take the fatal medication. There may be differences between the groups, but it seems natural that humans prefer some other person to ‘do the deed’. Over time there will be a move to make Voluntary Euthanasia more available in Ireland.
Preamble
The initial sentence promotes the Bill and “…provision for assistance in achieving a dignified and peaceful end of life to qualifying persons and related matters.”
Dignity is a complex issue. Some might question whether taking one’s own life—or being killed by another person—can ever be ‘dignified’ especially if that action is precipitated by a lack of self-worth.
Palliative Care focuses on the dignified and peaceful end to life—without directly killing the patient.
Interpretation (Definitions)
Even in the ‘Interpretation’, Irish doctors, nurses and HC professionals are being conscripted to provide AS/VE, despite 2000 years of medical ethics to the contrary: “attending medical practitioner is the registered medical practitioner from whom a qualifying person has requested assistance to end their life…”
And,
“healthcare professional” means a member of any health or social care profession…”
If society mandates the provision of AS/VE, there should be a new, well-regulated provider. Doctors and nurses should remain the patient’s care-giver, advocate, counsellor and should be able to shield a patient against coercion and involuntary euthanasia.
Qualifying persons: Section 7
“…a resident on the island of Ireland and has been for not less than one year.”
Remarkably the definition of “Qualifying Persons” includes citizens of other countries. In particular it includes most adult British Citizens living in Northern Ireland (which will cause ‘Euthanasia Tourism’ to the Republic.)
Ireland is likely to have some interesting experiences dealing with countries like Russia, China and Iran when killing their citizens (even if the person themselves are willing.)
Terminally ill: Section 8
Most of the definition for the ‘terminally ill’ seems reasonable though the Bill does not specify a time-frame within which the Qualifying Person is expected to die. (In other countries, legislation frequently sets a time limit on the prognosis such as ‘death expected within 6 months.’) Irish providers might need to be circumspect if life expectancy is 12, 24 months or longer because reasonable people will then question whether AS/VE is for a “Terminal Illness” as most understand the term.
Declaration: Section 9
You can do so by emailing [email protected]
Here is a sample analysis that you can use if you wish, published on our website and written by Dr. Kevin Hay.
***
This article examines An Bille um Bás Dínitiúil, 2020 to see what is being proposed for Ireland (and what was omitted) from a medical point of view.
This Bill legalizes Assisted Suicide and Voluntary Euthanasia [AS/VE] for terminal illnesses. Assisted Suicide is defined as the “…prescription of substance or substances which can be orally ingested by the person; (b) in the case of a person for whom it is impossible or inappropriate to ingest orally that substance or substances, by prescribing and providing means of self administration of that substance or substances.” [11.2.A/11.2.B] Assisted Suicide is the prime method to be used and Voluntary Euthanasia is allowed if “…it is not possible for the self-administer then the substance or substances may be administered.” [11.2.C]
In Canada AS and VE are both legal and optional. The vast majority of Canadian recipients choose the Voluntary Euthanasia and few withdraw once approved. Curiously, in Oregon—where AS is the only legal option—about 30% never fill the prescription or take the fatal medication. There may be differences between the groups, but it seems natural that humans prefer some other person to ‘do the deed’. Over time there will be a move to make Voluntary Euthanasia more available in Ireland.
Preamble
The initial sentence promotes the Bill and “…provision for assistance in achieving a dignified and peaceful end of life to qualifying persons and related matters.”
Dignity is a complex issue. Some might question whether taking one’s own life—or being killed by another person—can ever be ‘dignified’ especially if that action is precipitated by a lack of self-worth.
Palliative Care focuses on the dignified and peaceful end to life—without directly killing the patient.
Interpretation (Definitions)
Even in the ‘Interpretation’, Irish doctors, nurses and HC professionals are being conscripted to provide AS/VE, despite 2000 years of medical ethics to the contrary: “attending medical practitioner is the registered medical practitioner from whom a qualifying person has requested assistance to end their life…”
And,
“healthcare professional” means a member of any health or social care profession…”
If society mandates the provision of AS/VE, there should be a new, well-regulated provider. Doctors and nurses should remain the patient’s care-giver, advocate, counsellor and should be able to shield a patient against coercion and involuntary euthanasia.
Qualifying persons: Section 7
“…a resident on the island of Ireland and has been for not less than one year.”
Remarkably the definition of “Qualifying Persons” includes citizens of other countries. In particular it includes most adult British Citizens living in Northern Ireland (which will cause ‘Euthanasia Tourism’ to the Republic.)
Ireland is likely to have some interesting experiences dealing with countries like Russia, China and Iran when killing their citizens (even if the person themselves are willing.)
Terminally ill: Section 8
Most of the definition for the ‘terminally ill’ seems reasonable though the Bill does not specify a time-frame within which the Qualifying Person is expected to die. (In other countries, legislation frequently sets a time limit on the prognosis such as ‘death expected within 6 months.’) Irish providers might need to be circumspect if life expectancy is 12, 24 months or longer because reasonable people will then question whether AS/VE is for a “Terminal Illness” as most understand the term.
Declaration: Section 9
Like many countries this Bill allows for all of the assessments to be performed by just 2 doctors. Even though they act ‘independently,’ the doctors are most likely “like-minded” and in favour of AS/VE.
This Bill does not require any psychological testing before a doctor or nurse can become a provider. No psychological testing is required for those who provide AS/VE on an ongoing basis.
The 2 doctors must have: “separately examined the person and the person’s medical records” but there is no requirement to have known the patient prior to the request nor to communicate with the regular health-care provider or family, etc.
The two doctors must ensure that the: “person making it has been fully informed of the palliative, hospice and other care which is available to that person” but there is no requirement for the patient to have a palliative-care consultation, psychiatric assessment or review by a Social Worker, etc.
The Assisted Dying process can be revoked verbally: “A person who has made a declaration under this section may revoke it at any time and revocation need not be in writing.” The Bill is not clear whether the revocation then requires the process to start afresh if the patient changes their mind a second time and then wishes to continue the Assistance in Dying process.
The two doctors must ensure that the requesting person “has a clear and settled intention to end his or her own life which has been reached voluntarily, on an informed basis andithout coercion or duress.” [9.3.] Coercion and duress are sometimes subtle and pervasive. A survey in Washington State showed that 56% reported they felt they were ‘being a burden.’ Even decisions by government to limit health care or social services can coerce people into accepting AS/VE. (Ask Roger Foley in Ontario, Canada what happens where there is a lack of home-care services.) Brid Smith, TD—one of the sponsors of the Bill—verbalized a subtle form of coercion during the debate in the Dáil when she suggested that a person will choose Assisted Suicide/Euthanasia because “that choice is made out of love…for the life of those you are leaving behind.” The obvious corollary—which she did not verbalize—is that you do not love people if you choose to live with the terminal illness.
Assessment of capacity: Section 10
Of concern is that this Bill allows consent from a significantly demented patient: “The fact that a person is able to retain the information relevant to a decision for a short period only does not prevent him or her from being regarded as having the capacity to make the decision.”
Memory is an essential part of competence. We must be able to remember our previous decisions so we can amend them at a later date, if we so choose.
Assistance in Dying: Section 11
Waiting periods between the request for assistance and its provision are specified in the Bill. Over time this will be challenged by people who wish to proceed with their death immediately.
The process includes “The attending medical practitioner or assisting health care professional must remain with the person until the person has (a) self-administered the substance or substances or have it or them administered, (b) decided not to self-administer…or have it or them administered…is to be regarded as remaining with the person if the attending doctor or assisting healthcare professional is in close proximity to, but not necessarily in the same room as, the person.”
A particular concern is that the Bill does not require the attending medical practitioner (or their delegate) to witness the death of the Qualifying Person. Indeed, the attending medical practitioner does not even have to witness the ingestion of the poison (“not necessarily in the same room.”) This section does not specify what must occur in the event of the recipient having a complication at a time the attending medical practitioner is no longer available.
Conscientious objection: Section 13
This Bill does not require any psychological testing before a doctor or nurse can become a provider. No psychological testing is required for those who provide AS/VE on an ongoing basis.
The 2 doctors must have: “separately examined the person and the person’s medical records” but there is no requirement to have known the patient prior to the request nor to communicate with the regular health-care provider or family, etc.
The two doctors must ensure that the: “person making it has been fully informed of the palliative, hospice and other care which is available to that person” but there is no requirement for the patient to have a palliative-care consultation, psychiatric assessment or review by a Social Worker, etc.
The Assisted Dying process can be revoked verbally: “A person who has made a declaration under this section may revoke it at any time and revocation need not be in writing.” The Bill is not clear whether the revocation then requires the process to start afresh if the patient changes their mind a second time and then wishes to continue the Assistance in Dying process.
The two doctors must ensure that the requesting person “has a clear and settled intention to end his or her own life which has been reached voluntarily, on an informed basis andithout coercion or duress.” [9.3.] Coercion and duress are sometimes subtle and pervasive. A survey in Washington State showed that 56% reported they felt they were ‘being a burden.’ Even decisions by government to limit health care or social services can coerce people into accepting AS/VE. (Ask Roger Foley in Ontario, Canada what happens where there is a lack of home-care services.) Brid Smith, TD—one of the sponsors of the Bill—verbalized a subtle form of coercion during the debate in the Dáil when she suggested that a person will choose Assisted Suicide/Euthanasia because “that choice is made out of love…for the life of those you are leaving behind.” The obvious corollary—which she did not verbalize—is that you do not love people if you choose to live with the terminal illness.
Assessment of capacity: Section 10
Of concern is that this Bill allows consent from a significantly demented patient: “The fact that a person is able to retain the information relevant to a decision for a short period only does not prevent him or her from being regarded as having the capacity to make the decision.”
Memory is an essential part of competence. We must be able to remember our previous decisions so we can amend them at a later date, if we so choose.
Assistance in Dying: Section 11
Waiting periods between the request for assistance and its provision are specified in the Bill. Over time this will be challenged by people who wish to proceed with their death immediately.
The process includes “The attending medical practitioner or assisting health care professional must remain with the person until the person has (a) self-administered the substance or substances or have it or them administered, (b) decided not to self-administer…or have it or them administered…is to be regarded as remaining with the person if the attending doctor or assisting healthcare professional is in close proximity to, but not necessarily in the same room as, the person.”
A particular concern is that the Bill does not require the attending medical practitioner (or their delegate) to witness the death of the Qualifying Person. Indeed, the attending medical practitioner does not even have to witness the ingestion of the poison (“not necessarily in the same room.”) This section does not specify what must occur in the event of the recipient having a complication at a time the attending medical practitioner is no longer available.
Conscientious objection: Section 13
The section on conscientious objection starts off well: “…nothing in this Act shall be construed as obliging any medical practitioner or assisting healthcare professional to participate in anything authorised by this Act to which he or she has a conscientious objection.”
Then the ‘BUT’: “A person who has a conscientious objection referred to in subsection (1) shall make such arrangements for the transfer of care of the qualifying person concerned as may be necessary to enable the qualifying person to avail of assistance in ending his or her life in accordance with this Act.”
Many doctors consider the making of “arrangements for the transfer of care…” to be actively participating in the provision of SA/VE. Many perceive this to be unethical or immoral.
In Canada a similar proviso was made by the Supreme Court of Canada (“In our view, nothing in the declaration of invalidity which we propose to issue would compel physicians to provide assistance in dying.”) Despite that statement and despite the Superior Court of Ontario acknowledging there was indeed religious discrimination, the SCO supported the requirement for physicians to provide an “effective referral.” (Alberta has an effective self-referral route for patients.)
Obligation to keep and provide records: Section 14
“Not later than seven days after the medical procedure has been carried out, the attending medical practitioner: shall make a declaration in the prescribed form and manner confirming that the procedure has been carried out in accordance with this Act; and shall forward, or cause to be forwarded, copies of the declaration to the Registrar of Births, Marriages and Deaths and to the Review Committee.”
This does not clarify whether the documentation to the Registrar includes the Medical Certificate of the Cause of Death. The Bill does not state whether deaths caused by AS/VE must be reported to the Coroner.
Assisted Dying Act Review Committee: Section 15
“The Minister shall, by order, appoint a day to be the establishment day for the purposes of this Act. On the establishment day there shall stand established a body to be known as the Assisted Dying Act Review Committee.
This is the total definition for the Assisted Dying Act Review Committee (other than they must receive documentation from the attending doctors on each AS/VE.) The Bill should provide clarity on the composition, powers, structure and governance of this Committee.
Other than if Ireland does not legalize Assisted Suicide/Voluntary Euthanasia, ante-mortem review of each case by the Review Committee (**while the Qualifying Person is still alive) is the appropriate way to minimize the risk of a citizen/resident being killed in error.
Then the ‘BUT’: “A person who has a conscientious objection referred to in subsection (1) shall make such arrangements for the transfer of care of the qualifying person concerned as may be necessary to enable the qualifying person to avail of assistance in ending his or her life in accordance with this Act.”
Many doctors consider the making of “arrangements for the transfer of care…” to be actively participating in the provision of SA/VE. Many perceive this to be unethical or immoral.
In Canada a similar proviso was made by the Supreme Court of Canada (“In our view, nothing in the declaration of invalidity which we propose to issue would compel physicians to provide assistance in dying.”) Despite that statement and despite the Superior Court of Ontario acknowledging there was indeed religious discrimination, the SCO supported the requirement for physicians to provide an “effective referral.” (Alberta has an effective self-referral route for patients.)
Obligation to keep and provide records: Section 14
“Not later than seven days after the medical procedure has been carried out, the attending medical practitioner: shall make a declaration in the prescribed form and manner confirming that the procedure has been carried out in accordance with this Act; and shall forward, or cause to be forwarded, copies of the declaration to the Registrar of Births, Marriages and Deaths and to the Review Committee.”
This does not clarify whether the documentation to the Registrar includes the Medical Certificate of the Cause of Death. The Bill does not state whether deaths caused by AS/VE must be reported to the Coroner.
Assisted Dying Act Review Committee: Section 15
“The Minister shall, by order, appoint a day to be the establishment day for the purposes of this Act. On the establishment day there shall stand established a body to be known as the Assisted Dying Act Review Committee.
This is the total definition for the Assisted Dying Act Review Committee (other than they must receive documentation from the attending doctors on each AS/VE.) The Bill should provide clarity on the composition, powers, structure and governance of this Committee.
Other than if Ireland does not legalize Assisted Suicide/Voluntary Euthanasia, ante-mortem review of each case by the Review Committee (**while the Qualifying Person is still alive) is the appropriate way to minimize the risk of a citizen/resident being killed in error.
Forwarded from Pro-Life Ireland
Facebook has shut down the page for talking about ivermectin
Jesuit educated Irish politician Simon Coveney has been criticised for taking a taxpayer funded trip to Turkey while Mass remains closed thanks to his incompetent political party.
Catholics are being regularly shamed in Ireland's media if even one extra mourner shows up to a funeral, priests have been threatened with jail for allowing people to sit in on Mass and Catholics look set to be banned from Mass on the upcoming Holy Day of St. Patrick's Day once again.
It is an embarrassment to the Irish people that they allow authority to mock them like this. Where will Simon be next week, Ibiza?
Catholics are being regularly shamed in Ireland's media if even one extra mourner shows up to a funeral, priests have been threatened with jail for allowing people to sit in on Mass and Catholics look set to be banned from Mass on the upcoming Holy Day of St. Patrick's Day once again.
It is an embarrassment to the Irish people that they allow authority to mock them like this. Where will Simon be next week, Ibiza?
Irish journalists were asked not to report on Coveney's holiday to Turkey and they obliged. This should be a massive story.
Catholic Arena is the ONLY Irish website covering Coveney's holiday to Turkey.
Journalists have been told to protect their man.
https://www.catholicarena.com/latest/coveneysunholiday
Journalists have been told to protect their man.
https://www.catholicarena.com/latest/coveneysunholiday
Catholic Arena
Irish Media Refuses to Discuss Politician's Turkey Holiday — Catholic Arena
Catholic Arena are the only Irish based website covering this story.