The Committee recommends that the Government introduces legislation allowing for assisted dying, in certain restricted circumstances as set out in the recommendations in this report.
The remit of the Joint Committee on Assisted Dying was to consider and make recommendations for legislative and policy change relating to a legal right to assist a person to end their life and a legal right to receive such assistance.
The Committee also agreed that it could recommend that no legislative or policy changes be made. It has looked at the topic of assisted dying in general, rather than at draft legislation.
The Committee was established in early 2023 to consider and make recommendations for legislative and policy change related to a statutory right to assist a person to end their life and a statutory right to receive such assistance.
The Committee Members did not agree on any one form of wording on the topic, so the terms of assisted suicide and euthanasia are also used. The Committee recognises that the use of certain terms is contested.
Speaking on the launch of the report, Committee Cathaoirleach Deputy Michael Healy Rae said; “This report is the result of the work of the Committee over the past nine months. I was privileged to be Cathaoirleach for the Committee. I would like to thank the Committee Members who devoted their time and attention to this very complex issue. We did not always agree with each other, but all views were listened to and respected.
“The Committee has agreed that it could recommend that no legislative or policy changes be made and that the issues raised in this report be the subject of a debate in both Houses of the Oireachtas.”
“We worked cooperatively and collegially in order to give this important topic the attention it merits. The Committee Secretariat was extremely diligent in its work and the Office of the Parliamentary Legal Adviser provided us with clear and detailed background information. We are very grateful to the national and international experts and other witnesses who engaged with the Committee to examine end-of-life care, dying and assisted dying in detail.”
“This included experts in law, ethics, medicine, disability, palliative care, and psychiatry. A special thanks must go to the other witnesses who shared very moving personal stories about their experiences of end-of-life care. These heartfelt stories were difficult to tell and difficult to hear but they helped to inform the Committee Members and deepened our understanding of this sensitive topic.”
The report makes 38 recommendations, some of which are outlined below:
The Committee recommends that the Government introduces legislation allowing for assisted dying, in certain restricted circumstances as set out in the recommendations in this report.
The Committee recommends that the Optional Protocol to the United Nations Convention on the Rights of Persons with Disabilities should be ratified as a precondition of the commencement of assisted dying legislation.
The Committee recommends that the right to conscientious objection of all doctors and health workers directly involved in the provision of assisted dying should be protected in law.
The Committee recommends that any potential legislation on assisted dying uses clear and unambiguous terms and definitions, to avoid scope for uncertainty.
The Committee recommends that a person inquiring about assisted dying, following a terminal diagnosis, should be informed of, and assisted in, accessing all end-of-life care options, including palliative care.
The Committee recommends that palliative care and the operation of assisted dying should operate completely separately and independently of each other.
The Committee recommends that resources and funding for, and information about, palliative care services should be substantially increased, to ensure consistent and accessible services of the highest quality are provided throughout the country.
The Committee recommends that funding for assisted dying and palliative care be separate and distinct from one another, provided for in separate votes in the Department of Health budget.
The Committee recommends that research be carried out on the relationship between economic disadvantage and health inequalities, and the question of people feeling a burden.
This Committee recommends that where any person has failed to adhere to relevant statutory requirements governing assisted dying, he or she will have committed a criminal offence.
The Committee recommends that any potential legislation on assisted dying provides that where a person has been proven guilty of coercion, they will have committed an offence under the Act.
The Committee recommends that doctors and healthcare workers involved in the provision of assisted dying be trained to the highest level possible to identify coercion when assessing or treating a patient.
The Committee recommends that if a medical professional has been proven to have acted outside of the permitted regulations or has attempted to coerce an individual, they will have committed an offence under the potential legislation and may be held liable.
The Committee recommends the inclusion in any legislation on assisted dying of mandatory reporting to An Garda Síochána of any information or evidence concerning the issue of possible coercion in relation to assisted dying.
The Committee recommends that where capacity is in doubt, a functional test for decision-making capacity should be part of the assessment for eligibility for assisted dying.
The Committee recommends that any doctor involved in determining eligibility for assisted dying must have professional training in assessing capacity and voluntariness.
The Committee recommends that following an initial successful assessment for assisted dying that finds a patient eligible, if the patient temporarily loses decision-making capacity, then that eligibility is suspended for the duration of their incapacity.
The Committee does not recommend that advanced healthcare directives allow for individuals to make requests for assisted dying. However, consideration of the issue may be included in any review of assisted dying legislation.
The Committee recommends that the updated palliative care strategy should be published by the Department of Health without delay and that palliative care and the operation of assisted dying should operate completely separately and independently of each other.
The Committee recommends that if assisted dying is introduced, an assessment by a qualified psychiatrist should be required in circumstances where the patient is deemed eligible but there are concerns about whether the person is competent to make an informed decision.
The Committee recommends that eligibility for assisted dying should be limited to Irish citizens or those ordinarily resident in the State for a period of not less than twelve months.
The Committee recommends that assisted dying should be limited to people aged 18 or over.
The Committee recommends that only a person diagnosed with a disease, illness or medical condition that is:
The Committee recommends that two formal requests for assisted dying must be made, with a set specified interval between. At least one of these requests must be recorded in writing, and before two independent witnesses.
The Committee recommends that any potential legislation for assisted dying should establish a national body with sole responsibility for assisted dying services and related supports.
The Committee recommends that all assisted dying applications and related processes should be overseen and governed by the independent national body.
The Committee recommends that family members, carers, guardians or holders of an enduring power of attorney cannot request assisted dying in the interest of another person.
The Committee recommends that any potential legislation for assisted dying should provide a means of access to treatment for individuals who require assistance during the administration.
The Committee recommends that if assisted dying is legislated for, a doctor or nurse practitioner must be present for the duration of the assisted dying process and must remain until after the patient’s death and must account to the responsible authority for any remaining substances.
The Committee recommends that any assisted dying legislation include a provision for a formal review after three years of the operation of the legislation.
The Committee recommends that any assisted dying legislation must include definitions for terms used, including, but not limited to, medical descriptions of the methods permitted under the Act.