IN ITS FIRST meeting, the Oireachta Committee on Assisted Dying grappled with whether people should be able to access any service on the grounds of disability alone, with TDs and senators taking diverging initial views.
Sinead Gibney, the Chief Commissioner of the Irish Human Rights and Equality Commission (IHREC), who appeared in front of the committee today, told members that one of the key safeguards that should be considered is the exclusion of disability as grounds for assisted dying care.
The first public meeting of the meeting took place almost three years after the Dying with Dignity Bill passed through the Dáil.
IHREC’s Head of Legal Michael O’Neill clarified that the commission is recommending the exclusion of disability as the “sole reason” for someone accessing any future assisted dying service, but that this should not stop people who are “coming to the end of [their] life due to a disability” from accessing that service.
“The fact that a person is old or disabled should not in and of itself be the reason,” he added.
Gibney added that there should be, in the view of “reasonable medical judgement”, a high probability that a person will die within a set timeframe to be eligible for any assisted dying services.
She clarified that IHREC does not at present have a position on whether legislation should be changed around assisted dying or not as of yet.
Gibney also advised that lawmakers will have to develop safeguards that will protect at-risk groups who could be targeted by people who would stand to benefit through their death, and could take advantage of “loopholes” in future legislation.
She added that people who may consider opting for any future assisted dying service must also have access to alternatives, including up-to-standard palliative care.
Rachel Woods, the Assistant Secretary to the Department of Justice told the committee that suicide was decriminalised in 1993, but the the offence for a person to aid an attempt at suicide by another person was retained, “given perceived dangers in its abolition”.
Woods said that clarification of the law was given in the judgement made in the 2013 Supreme Court case of Marie Fleming, a woman who had multiple sclerosis and campaigned to get orders allowing her to have a lawful, peaceful, and dignified assisted death at the time of her choosing without anyone being prosecuted as a result.
She noted that while the Supreme Court called the case “tragic”, they ultimately ruled that there is no constitutional right to arrange for the ending of one’s life at a time of one’s choosing.
“The Court clarified that its judgement did not prohibit the Oireachtas from legislating for assisted suicide, assuming appropriate safeguards could be introduced,” Woods added.
Senator Lynn Ruane questioned the moral basis of the exclusion of disability as a sole reason for eligibility for assisted dying.
“Are we putting forward ideas on the rights of disabled people but then diluting those rights?” she asked.
What do we mean by coming towards the end of life? If we are measuring it against how long you have left to live, we may have someone with an acquired disability who has ten years, and has explored their options.
“Maybe disability alone is the reason why some people want to die. Do we risk preventing them from engaging in their right to make a decision, because they have ten years rather than ten months?” she said.
In reply, Gibney said that in many cases “having a disability isn’t the issue alone” for people. “It’s society and not being able to participate fully,” she added.
Gibney then put forward that it is helpful to “extend the concept of coercive control” to consider how, through a lack of services and access to care, education, transport and facilities, society as a whole can be “coercing people into having a life that is unpleasant”.
Protecting people from being coerced or manipulated into assisted dying by those who may stand to benefit from them doing so is one of the safeguarding challenges being considered by the committee.
Weighing in on the debate, Gino Kenny TD said that while the committee must consider how best to protect people’s right to life, he also believes that people should have a “fundamental right to have a say over your life. ”
“If one of the fundamental thoughts in their head is on how their life is going to end, if assisted dying was there, they would at least have a choice,” he added.
Kenny said that in other countries where assisted dying has been legislated for, “the evidence is just not there” that “people have been coerced”.
Senator Mary Seery Kearney said that she has concerns that introducing assisted dying will mean that “we arrive at a stage where people will be afraid to complain of their suffering”.
She elaborated that she fears that assisted dying will be suggested as an option for people in this situation.
“How would that right be advertised to people? Are they given a leaflet if they are told they have six months left, as we cannot assume they know about it, but the fact of that information, is that itself a trigger?”
“By having the conversation alone, is that making a statement on the value of life for those people?” Kearney questioned.
Assistant General Secretary in the Department of Justice, Rachel Woods, said that medical professionals already put safeguards into practice when discussing treatment options that could possibly cause death as a consequence.
“There are rights to refuse treatment,” she added.
Some TDs admitted that they have conflicting concerns on the prospect of changing the law around assisting dying.
James Lahart TD said that the next eight months will be a “steep learning curve” for all of the committee members.
Alan Farrell said he will “struggle with the moral and ethical side” of the debate around assisted dying in the course of the committee’s work.
“Everybody has concerns and trepidation over what we are getting ourselves into,” he said.
“On the basis that suicide is no longer illegal, what right do we as able bodied, relatively healthy people to tell people what they cannot do?,” he asked.
“Intertwined with that concern, I have huge concerns about the unintended consequence and impact that any bill could have if it was to disintegrate or lead to others taking advantage of vulnerable persons,” Farrell added.
Senator Ronan Mullen repeatedly questioned Gibney on whether it was the case that IRHEC was in fact going to recommend that the Oireachtas legislates to introduce an assisted dying framework.
Gibney stated that she wouldn’t rule out the commission taking a stance on the issue in the future, but that this was not the case to date.
Mullen also repeatedly asked Woods if he would, hypothetically, be prosecuted for taking steps to intervene in someone’s suicide, and whether people have a constitutional right to complete suicide.
Woods clarified that suicide is not prohibited under the constitution.
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