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A Thought Experiment: Voluntary Assisted Dying (VAD), how could a person’s choice be respected?

End of Life Ireland (EOLI) is a volunteer-led group seeking to foster conversation about end-of life issues. Alan Tuffery is a committee member of EOLI and below he thinks forward on how a person could express the scenarios in which they would like to access VAD.

My last post about the fact Voluntary Assisted Dying (VAD) is not available in Ireland at present, stimulated a discussion within our End of life Ireland weekly meeting. The main thrust of this discussion was whether the Advance Healthcare Directive could be suitably amended to include an option for VAD in certain circumstances. Since VAD is not in fact an option at present in Ireland our discussion was of course hypothetical.

Let’s indulge in a thought-experiment

Any indication of a preference for VAD would be just that — a preference. It would have to make plain that it is not a request to anyone to do anything illegal. Remember, at present:

If the Directive were amended to include a preference of VAD, it would be necessary to say in what circumstances you would want to have VAD. For example, such a circumstance might be intolerable pain or suffering with no reasonable prospect of relief. One could go on to specify other conditions, such as loss of speech or having dementia. However, any such preferences wouldn’t qualify you under the terms of the (now defunct) Dying With Dignity Bill, because the Bill only provided for VAD in the case of (carefully defined) terminal illness . 

What would be the value of amending the Directive to include such a preference? 

Well, the Bill does specify that the individual must have a ‘clear and settled intention’ to seek VAD. So such an indication in your Directive could be used as evidence of the long-standing and considered nature of the request, however hypothetical. If one had to go to court to establish this point, the process would take so long, it would not be of any use to the individual. 

My conclusion from all of this is to leave well along and keep the Advance Healthcare Directive as simple as possible. (A good general principle in life, I find!) It serves its purpose well as it is. 

When Ireland finally passes a Bill permitting VAD, I imagine that one of the first things that will happen is that a standard form will be drawn up that is clear and consistent with the provisions of the Act

One might speculate that this could happen as one of the functions of the Office of the Decision Support Service….but that’s quite enough speculation for one post!  

On to making a will for the next post!