Dying with Dignity Bill: Is Ireland Ready?

Image Credit: Sinéad Mohan

In light of the introduction of the Dying with Dignity Bill to Dáil Éireann, Vanshika Dhyani explores the varying stances on the practice at home and abroad

Assisted suicide is “the voluntary termination of one's own life by administration of a lethal substance with the direct or indirect assistance of a physician”. In the present day, euthanasia and physician-assisted suicide are permitted in several parts of the world, including Australia, Belgium, Canada, Colombia, Luxembourg, The Netherlands, Switzerland, as well as parts of USA. However, in most nations, euthanasia is still punishable by law. The 15th  September 2020 saw the introduction of the Dying with Dignity Bill in Ireland. 

The Dying with Dignity Bill is in favour of assisted dying. Introduced by Deputies Gino Kenny, Mick Barry, Richard Boyd Barrett, Paul Murphy and Bríd Smith, the bill will permit terminally ill citizens to legally avail medical aid to end their own lives. According to the 1993 Suicide Act: “A person who aids, abets, counsels or procures the suicide of another, or an attempt by another to commit suicide, shall be guilty of an offence and shall be liable on conviction on indictment to imprisonment for a term not exceeding fourteen years”. While attempted suicide has ceased to be a crime as stated by Irish law, a person abetting the suicide of another person is still punishable, rendering assisted suicide and euthanasia illegal. 

After it was initiated and presented to the principal chamber, the Bill completed Dáil Éireann’s Second Stage and entered the committee stage on the 15th of September.

Bill twenty-four of 2020 is entitled “an Act to make provision for assistance in achieving a dignified and peaceful end of life to qualifying persons and related matters.” Presently, the Bill describes qualifying persons as those who;

a) are terminally ill 

b) have a clear and settled intention to end their own life and have made a declaration to that effect in accordance with section 9, and

(c) on the day the declaration is made, the individual is: 

i) aged 18 or over, and 

ii) a resident on the island of Ireland and has been for not less than one year. 

Arguments in support of physician-assisted suicide advocate equality in the ministration of terminally ill patients both on and off life support.  According to a study conducted by Glasgow University's Institute of Law & Ethics in Medicine in 1997, it was reported that 72% of pharmacists and 56% anaesthetists supported the legalisation of physician-assisted suicide, and were of the view that "if a patient has decided to end their own life then doctors should be allowed in law to assist". Those in favour also advocate the patient's decision-making capacity and personal liberty. Dr Louise Campbell, professor of medical ethics at NUI Galway believes that the word ‘suicide’ is inappropriate to describe the procedure, as the undertaking is an outcome of a medical decision taken by a patient after consulting a healthcare professional. Furthermore, Des Kenny, chairman of the Independent Living Movement Ireland spoke in support of the Bill; “I would not want to live the end of my life at a total remove, or without contact, or in excruciating pain,” he said. He also expressed his views on exercising personal autonomy by saying; “I would like to be able to make that decision when I reached a certain stage of disability that locked me away from the love of those around me or my ability to be social”. 

The arguments against the legalisation of assisted dying are based on ethical and moral dilemmas, and those opposed maintain that the practice contradicts the “do no harm” principle of medicine. The Hippocratic Oath, the fundamental essence of medical practise,  dictates "I will give no deadly medicine to anyone if asked, nor suggest any such counsel.".

A 2017 study conducted by the Royal College of Physicians of Ireland reviewed “The Matter of Assisted Suicide.” The study was a collective effort of professionals from different areas of medicine, such as Geriatric Medicine, Neurology, Palliative Medicine, Respiratory Medicine, Rehabilitation Medicine, and Psychiatry. After weighing the arguments of both position and opposition, the RCPI published an official opposition stating that it did not support the “introduction of any legislation supportive of assisted suicide because it is contrary to best medical practice.” 

While many stand divided on the issue, there has been a growing support for neutrality. Healthcare organizations have been asked to take an unbiased stance on the subject to accommodate contrasting views. In 2009, the UK Royal College of Nursing announced its neutral position on assisted dying. This was followed by the medical societies of California and Colorado, as well as the District of Columbia from 2015 to 2016. 

Currently, "both euthanasia and assisted suicide are illegal under Irish law. Depending on the circumstances, euthanasia is regarded as either manslaughter or murder and is punishable by up to life imprisonment". If the Act is passed it will become legal for a medical professional to make provisions to assist individuals in taking their own life, as defined in section 11 of the Act. A subsequent amendment of Criminal Law (Suicide) Act 1993 will dictate that “A person who provides assistance in accordance with this Act shall not be guilty of an offence” and “Nothing in this section [Section 2] shall render unlawful the provision of assistance to a person in accordance with the Dying with Dignity Act 35 2020.”

The Dying with Dignity Bill was passed uncontested by the Dáil on the 8th October 2020.  Following the Committee Report and Final Stage, the Bill will be passed to the Seanad. Before it can be signed into law by the President, its general principles will be debated in the upper house. It will then be examined section by section, proposed amendments will be taken into consideration, and final statements on the Bill will be presented.