Dr. Paul D'Alton
Deficiencies rife in flawed Dying with Dignity Bill
Proposed legislation should be referred to respected Citizens' Assembly.
The right to die already exists in Ireland. Suicide is legal, and it is also legal for an adult to refuse medical treatment that may prolong their life. What is not legal is to assist someone to end their life.
The Dying with Dignity Bill (2020), which is currently making its way through the Oireachtas, is an attempt to legislate for assisted dying. This bill, however, is fundamentally flawed and, if enacted, will pose significant risk for some of the most vulnerable people in our society.
The central argument made by those who support this bill, and assisted dying in general, is personal autonomy; the right of the individual to decide and pursue a particular course of action. Accordingly, when it comes to death, the individual should have the right to decide the circumstances and the timing of their own death when faced with a terminal illness.
Advancing personal autonomy has been a significant driver behind the social changes witnessed in Ireland in recent years.
In 2015, the country voted to extend the right to marry to same-sex couples. In the same year, the Gender Recognition Act, allowing people to self-declare their chosen gender, was passed by the Oireachtas. In 2018, the nation voted in favour of repealing the Eight Amendment and thus legalising abortion.
In the aftermath of the repeal of the Eight Amendment, many commentators cited assisted dying as the next big issue. In many ways, the choice to end one’s life in the face of terminal illness is the ultimate expression of personal autonomy.
Advocates for same-sex marriage and abortion used personal stories very effectively in their respective campaigns. These stories drew deeply on our humanity and compassion. The same approach will be effective in the assisted-dying debate.
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However, a humane and compassionate response is not enough.
Comprehensively considered and detailed legislation to safeguard the most vulnerable is needed. The Dying with Dignity Bill (2020) falls well short in this regard and is likely to bring serious unintended consequences for some of our most vulnerable citizens.
The provisions in this bill to protect those who have significant mental health difficulties are inadequate.
The bill does not, for example, require someone requesting assistance to end their life to undergo mental health assessment.
There are serious questions concerning the provisions of this bill to protect those who are cognitively compromised or those with intellectual disabilities.
The very definition of terminal illness contained in the bill is inadequate; there is no requirement that the patient with a terminal illness should be approaching the end of their life. Further, the provisions of the bill to regulate those who assist in ending another person’s life are insufficient.
The Dying with Dignity Bill is deficient and beyond remediation. We have a respected and tried and tested system that has served us well in addressing such issues of complex social importance: the Citizens’ Assembly.
The most compassionate thing we can do is suspend the current bill and convene a Citizens’ Assembly at which the rights and responsibilities concerning assisted dying can be fully considered.
Dr Paul D’Alton, former president of the Psychological Society of Ireland, is Associate Professor of Psychology, UCD and Principal Clinical Psychologist at St Vincent’s University Hospital.
Originally published in The Irish Independent 29/01/21.