Greg DalyA Dublin conference has heard that assisted suicide threatens the weakest among us, Greg Daly reports
Henk Reitsema’s grandfather was 80 years old when he was killed.
Living in a Dutch long-term care facility after a stroke that had left his left side partially paralysed, he was visited by his wife daily and was fully capable and loved life, active on the home’s representative committee and regularly beating visiting relatives at card games, when he was diagnosed with non-Hodgkins lymphoma.
The doctors began treating to terminate, issuing high doses of morphine and withholding hydration, something Mr Reitsema’s aunt discovered a few days later when she tried to give his grandfather water but was stopped from doing so. The following day, a week after being diagnosed with an illness that in normal conditions would have ended his life in a few years, he was dead.
A few years later Mr Reitsema’s grandmother, who had trusted in the doctors’ treatment of her husband, moved away from her family and church community to a Christian-run old person’s home 200km away – about as far away as one can go while remaining in the Netherlands – in order to be safe from doctors who had internalised the idea that killing can be a form of palliative care.
Mr Reitsema’s story was but one of many told at the inaugural Hope Ireland conference, held in the RDS at the weekend. Conference organiser and director of Hope Ireland, Dr Kevin Fitzpatrick, who has been disabled for 42 years after a spinal injury, explained that the law in Ireland, currently under pressure from those who would seek the legalisation of assisted suicide, protects vulnerable people and saves lives.
“It’s entirely fair to link the concepts of euthanasia and assisted suicide”, according to Trinity’s Professor Emeritus William Binchy, who explained that while it’s philosophically and logically possible to distinguish between the two, it’s quite plain from international legal developments that “in the minds of the courts, the two issues are integrally related”.
Mapping out in broad brushstrokes the history of legal developments in what he called “a story that’s unfolding, and unfolding with ever-increasing speed”, Prof. Binchy explained that contrary to popular myth, 1993’s Criminal Law (Suicide) Act did not create a right in Irish law for people to take their own lives; rather, he said, by decreeing suicide was no longer a crime, its practical effect was to remove criminal sanctions for unsuccessful attempts at suicide. The law, he said, was based in “humane concern for people who were already in situations of difficulty”.
The 1996 Ward of Court case, which followed the 1992 British Tony Bland case in classing the supply of food and water as medical treatment and effectively ruled that the continuation was life was not a good in itself, nonetheless reiterated that there is no right to suicide in Irish law when the Supreme Court observed that nobody “has the right to terminate or to have terminated his or her life, or to accelerate or have accelerated his or her death”.
The 1993 law makes it an offence to aid, abet, council, or procure the suicide or assisted suicide of another person, and the 2013 High Court case which ruled against Marie Fleming found that the State’s duty to protect vulnerable people can justify such a complete prohibition on assisted suicide. The evidence presented in the case, the court found, showed that it would be almost impossible to legalise assisted suicide without exposing the law to abuse through coercion, complacency, or through vulnerable people hiding their true motives feared being a burden on their loved ones.
Troublingly, though, in the Fleming case the Supreme Court did not conclude that the State was obliged to maintain a complete ban on assisted suicide in order to protect the vulnerable. In a paragraph Prof. Binchy described as “somewhat Delphic”, the court ruled that were the legislature to produce legislation in this area, clearly modifying the absolute prohibition on assisted suicide, the court would scrutinise it in light of constitutional values.
In other words, Prof. Binchy explained, “the court gave an indication that it was not necessarily averse to legislation on this particular issue”.
The line that countries are entitled to maintain a complete ban on assisted suicide but are not obliged to do so, has been of a pattern with most judgments elsewhere on these issues, until this February when Canada’s Supreme Court broke with the legislative trend, striking down laws banning physician-assisted suicide as incompatible with the Canadian Charter of Rights and Freedoms.
It remains to be seen whether other countries will follow the Canadian example, but in the meantime, according to Prof. Des O’Neill, a consultant physician in geriatric medicine and director of Dublin’s Centre for Aging, Neuroscience and the Humanities, those arguing for assisted suicide are feeding prejudices against the old, disabled, ill, and infirm that would not be tolerated against others.
Questioning why assisted suicide seems to be societally placed on a higher ethical plane than other suicides, Prof. O’Neill noted how we are rightly horrified by how three times as many people die of suicide in Ireland as die in road traffic accidents, and yet there is a “determined failure not to link this with the tragedy of assisted suicide”.
In countries where assisted suicide has been legalised, it has been availed of most often, he explained, not by older people, but by “middle-aged and early old-aged” people who fear losing their capacities and making things difficult for others. Pointing to the late Terry Pratchett’s 2012 documentary Choosing to Die, he said that “not wanting to be a burden is the greatest burden of all”.
Autonomy, he said, does not exist in a vacuum, citing Argentine essayist Aldo Pellegrini’s observation that “we have forgotten how all autonomy is exercised in the embrace of others”.
Part of the challenge, Prof. O’Neill said, is to develop our ethical articulacy, restoring to public thinking the language surrounding such unfashionable virtues as prudence and temperance. Insisting that the discussion around assisted suicide and euthanasia “must be debated in pluralist and universal terms”, he cited how Jurgen Habermas came to see religions as sources of “virtuous thinking”, and developed a kind of “methodological atheism” where we seek to excavate the “thought content” in the great religions, without resting on religious dogma.
Without serious thinking on this issue, we risk the bleak futures mapped out in the such countries as the Netherlands, where 16% of people currently die each year from ‘terminal sedation’, and where euthanasia as strictly defined in law has been rising by about 14% year on year, with more than 5,500 of the country’s 140,000 or so annual deaths so occurring.
“Where one legalises euthanasia, incremental widening of the law is unavoidable,” Mr Reitsema observed, with Dr Fitzpatrick agreeing, pointing out that people with disabilities and the elderly will become threatened if Ireland’s laws in this area are weakened.
“Laws which permit people to give suicide assistance are dangerous”, he said.
Footage from the conference will be available at Hopeire.com