‘Complex and profound issue’: Committee on assisted dying to hold first public session next week

THE JOINT OIREACHTAS Committee on assisted dying will begin its public deliberations on Tuesday.

The cross-party panel of five senators and nine TDs will examine whether a system should be implemented to allow terminally ill people to avail of medical assistance to die in certain circumstances.

It was established in private seven weeks ago and will meet in public for the first time this coming Tuesday to look at the legal and constitutional issues.

This will be the first of six modules to be examined and around 100 potential witnesses have been invited to give testimony.

Assisted dying is the act of deliberately providing medical assistance to another person who wishes to end their own life.

Currently, assisting someone in ending their own life is illegal under Irish law, while taking one’s life is not.

Under Section 2 of the Criminal Law (Suicide) Act 1993, anyone who “aids, abets, counsels or procures the suicide of another [person]” can be convicted and imprisoned for up to 14 years.

‘Political will’

People Before Profit TD Gino Kenny tabled the Dying with Dignity bill in 2020, and he told The Journal that he “would like to see that the committee recommend legislative change around assisted dying”.

He explained: “We’ll look at the whole spectrum of assisted dying; the legal and constitutional issues, safeguards, international contexts, ethical issues.

“There’s a lot to cover, the committee will meet for around 26 weeks and all sorts of groups and individuals will be invited in.

“At the end of that process, the committee will then make recommendations and provide them via a report put before the Dáil.”

It had been suggested that the committee should not meet until September in order to avoid interruption from the summer recess.

However, Kenny told The Journal that such a delay was “never a runner”.

“There’s no sense in delaying it until September,” said Kenny.

“There’ll be five sessions before the summer recess, and then we’ll continue the committee’s work in September and finalise its recommendations around mid-March.

“There is probably around one year left of the lifetime of this government and I would hope that the government will then take the issue on.

“But that depends on the recommendations from the committee and I don’t want to pre-empt it but I make no bones that I want to see this being legislated for at the end of this process.

“All polls indicate that a majority of people will support legislative change in Ireland, it’s unequivocal, but we have to hear the broad spectrum of the debate and I look forward to taking part in that.”

Kenny added: “Other countries have legislated for this and I have no doubt it can be done here if there’s a political will.

“People can have a choice, because that’s what it’s about, and people should have a choice in relation to a situation where they may avail of assisted dying”.

‘Respectful’

Kenny said he is also hopeful that the public debates can be run in a “respectful manner”.

“There will be people that will come before the committees that I agree and disagree with,” Kenny tells The Journal.

“It should always be in a respectful manner, it doesn’t need to be confrontational and divisive, all that can be omitted.

“It’s a very complex and profound issue and we should all be mindful of those that are listening.

“We are public representatives and we all have an onus and responsibility to use our words carefully and respectively and that’s always what I try to do regardless of what people’s opinions are.”

Such use of words has already become an issue.

Kenny uses the term “voluntary assisted dying” but Independent senator Rónán Mullen, who sits on the committee, objects to the term.

Speaking to The Journal, Mullen said he objects to using “assisted dying because it’s euphemistic”.

“I fully acknowledge that somebody like Gino would regard it as pejorative,” said Mullen.

“On the one hand, ‘assisted dying’ is to euphemistic and almost too normalising, on the other hand, you could say ‘assisted suicide’ is pejorative.”

However, Kenny said: “Suicide and assisted dying are two separate issues, and I think it’s important not to conflate the two issues.

“There are those who want to conflate the issues and want to weaponise the word ‘suicide’, that’s what they’re trying to do and it’s completely distasteful for them to do it.”

While Kenny adds that he “can’t prevent people using all that terminology”, he said he will always use the phrase “voluntary assisted dying”.

“It’s a voluntary decision where somebody needs assistance when they’re dying,” Kenny told The Journal.

“The committee have at least said they are not going down that road and it is ‘assisted dying’.

“I respect Rónán Mullen’s views, but I think it’s very distasteful.”

Meanwhile, Mullen said there is a “body of thought that says ‘assisted dying’ is the umbrella term which divides into ‘euthanasia’ and ‘assisted suicide’”.

“In other words,” said Mullen, “euthanasia is different from assisted suicide because it’s directly done by a healthcare professional.

“Whereas assisted suicide is the person’s choice to end their lives and they are facilitated by the prescription of a tablet or something like that.

“My own view is, if we are going to say that assisted dying is made up of euthanasia and assisted suicide at least that’s clear.”

While Mullen said he “understands Gino’s point of view”, he added that it is a “political point of view”.

“The fact remains that if we are going to legalise this, we are going to have to change the current law in Ireland which criminalises assisting another person with suicide.

“If it were not assisted suicide, we wouldn’t have to change that law,” said Mullen.

Mullen added: “It is understood clearly by the committee that we have the power not to recommend any change in the law.”

‘Unintended consequences’

Mullen told The Journal that one of the fix modules to be considered is that of “unintended consequences”.

“For example, some people say if you allow euthanasia, you will cause some people to feel that their lives are less valued by society and they come to feel a burden.

“That would be one aspect or an example of a social concern that some people might have.”

Mullen added: “Through all of this will be a consciousness of three key constituencies: those who are terminally ill or contemplating death within a relatively short time period; those who have disabilities, there are many in that sector who would be very nervous about this because they see their lives as being devalued by implication; and older citizens.

“Do we do enough to value their contribution in society, or do we cause the kind of neglect and despair that leads people to put less of a value on their own continuing to live?”

Mullen also told The Journal that he was successful in “arguing for the committee to also consider other relevant health care measures”.

He explained: “In other words, we might want to say, ‘we don’t want to change the law on assisted dying but we do want better quality palliative care and we need better facilities and more clarity around end of life care.

“We need more clarity, for example, that you don’t have to go to extraordinary means to preserve life if you’re causing suffering.

“People don’t always realise there is a difference between acting to deliberately end somebody’s life on the one hand, and not intervening in an extraordinary way to keep them alive when they are dying.

“There is a time when people can say, ‘I don’t want treatment beyond a certain point’, and that’s not euthanasia.”

However, Mullen said that he is committed to “listening very carefully” to those who will come before the public meetings.

“The test of all of us, myself included, will be if we sincerely engage with the people we disagree with, as well as the people we agree with,” said Mullen.

“Obviously, I am very, very nervous about any form of euthanasia or assisted suicide because I wonder what it will do to our society and I wonder whether people are sufficiently aware of how much can be achieved with excellent quality palliative care.

“Having said that, I will listen very carefully to people who come in and talk to us about their life experience, to the legal people who can tell us what the law says, to those who work on the front line in palliative care.”

Mullen added that the committee has to also “consider the economic issue too, and whether changes in the law would cause people to be more economically vulnerable”.

He said he had come across “stories about insurance companies in Canada (where assisted dying is legal) that won’t pay for certain types of cancer treatment but will pay for your euthanasia”.

“People who are not fans of the slippery slope theory of politics just need to look at what has happened in some of these countries once the law changed,” said Mullen.

“A survey in Canada recently suggested there’s a very high number of people in favour of euthanasia for the homeless, for example, presumably if they consented to it, but what kind of a response is that to human suffering.”

According to a poll carried out by the public opinion firm Research Co, 28% of Canadians would agree to allow adults in Canada to seek medical assistance in dying due to homelessness.

27% said they would include poverty in the expanded guidelines as reasons to seek medical assistance in dying.

“I need to hear in sincerity from people on the other side of the argument, who say, ‘it is my life to do with as I want’”, said Mullen.

“But I think we all know that autonomy isn’t the only argument here,” added Mullen.

“There are other social consequences, personal consequences, if the law changes for you, it also changes the world in which I live. You might not want to impact my world, but it does.

“So, those are the kinds of issues we have to consider, autonomy is one aspect of ethics, but so also is social responsibility, human equality, human dignity and so on.”