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(5/5) Why not voluntary assisted dying?

This is the final in a series of blogposts telling my story of making my end-of life arrangements. If you missed the earlier posts catch up here

In my last post, I completed the story of the Advance Healthcare Directive: what it is, how to fill it out, and who should know about it. In this post I want to talk about the one thing you can’t ask for in your Directive, namely Voluntary Assisted Dying.

Obviously, since you are on the End of Life Ireland (EOLI) website, you will know that we support the Dying With Dignify Bill which, if passed, will permit Voluntary Assisted Dying (VAD) for individuals with a terminal illness. The other aim of our activities is to promote conversations about end-of-life issue; these blogposts are part of that. 

At present, the law in Ireland only allows an individual to refuse medical treatment. The introduction to the Advance Healthcare Directive makes this limitation very clear: 

Now, in the thirty or so countries where VAD is available — for over 200 million people — a formal declaration is required to start the process of requesting VAD. In Ireland, it is a serious criminal offence to assist someone to commit suicide — even though suicide is no longer a crime. Assisting someone to end their life is punishable by up to 14 years imprisonment. 

It follows that that no-one can ask for an assisted death because it might put someone in danger of prosecution. 

The Dying With Dignity Bill, if passed, will remove that criminal offence and permit doctors to provide or administer a lethal dose — in certain very restricted circumstances. Briefly, the circumstances are that two doctors have independently confirmed a terminal illness and the patient has demonstrated a ‘clear and settled intention’ to seek VAD, by means of a declaration. As in the Advance Healthcare Directive, it will be necessary to demonstrate that you are mentally competent to make the decision. 

There are those who fear that allowing VAD at all might result in some unintended extension of the option to various ‘vulnerable groups’. International experience shows that the safeguards work and there is no unregulated extension of provisions. Doctors, who are primarily involved in the process, are well-practised at assessing competence as well as the likely clinical outcomes of the various terminal illnesses. Assisting someone with a terminal illness to end their life is major decision, not only for the individual, but for the doctors as well. Those doctors who choose to be involved in the process are not going to take it lightly or indulge in a box-ticking exercise. 

More details on all of these arguements are available in our submission to the Justice Committee which is currently looking at adding amendments to the Bill.