(7/14) What Are the Legal and Ethical Issues?

The Oireachtas Joint Committee on Assisted Dying has been asked to examine the ‘legal and ethical issues’ around ‘assisted dying’. Here are my thoughts.

Legal background

I am not a lawyer and so not competent to deal with the more technical aspects of legislation for assisted dying (or Voluntary Assisted Dying — VAD —as I prefer to call it). In Ireland The Suicide Act of 1993 decriminalised suicide but it also created a new offence punishable by up to 14 years imprisonment of assisting someone else to end their life. The Act treats that as murder.

In the case of healthcare personnel, even being charged with such an offence would mean loss of reputation and probably their ability to practice, regardless of the outcome, not to mention the stress for several years while the prosecution runs its course.

The Marie Fleming case in 2013 determined that there is no constitutional bar to introducing a law permitting assisted dying. The chief effect of amending the law to permit VAD would be to remove the offence of assisting someone to end their life. This could allow healthcare personnel to provide and administer drugs which will end someone’s life without fear of prosecution — as long as they meet the legal conditions.

It is not so long ago that there was a prosecution in Ireland for attempting to make travel arrangements for someone to go to Switzerland to end her life. Such a prosecution is extremely rare in UK and Ireland (which have similar laws) but the threat of reporting or prosecution could be enough to cause great distress. The defendant was acquitted and that may mean that further prosecutions are unlikely, but, as the law stands, the threat of reporting or prosecution remains.

One issue that causes concern is what goes on the death certificate as the ‘cause of death’. ‘Suicide’ may invalidate some insurance policies. In practice, laws enabling VAD insist that the cause of death shall be the underlying condition (cancer, MS etc) and not VAD. This protects the individual’s beneficiaries from loss of benefits.

Ethical considerations

There are two principal ethical conditions that need to be considered; religious views and the rights of individuals. I will deal with religious views in more detail in a later article, but for now, I will just say that ‘assisted dying’ is a choice, it is voluntary, and anyone who does not approve of it need not seek it. There are obvious parallels in relation to abortion or same-sex marriage.

The question of the rights of individuals as against those of society is also complicated and were discussed at length in previous Oireachtas Committees (especially the 2018 report, available on the EOLI website check]). It seems to me that compassion for the suffering of individuals outweighs any possible damage to society as a whole. Permitting VAD would reduce suffering in society for the dying individual and also their family and wider circle of friends and acquaintances. The goal of a more compassionate society seems worthwhile.

Alan Tuffery is a member of End of Life Ireland. We are a voluntary group advocating for legislation to allow Voluntary Assisted Dying in Ireland. This is the seventh in a series of fourteen short articles on issues about voluntary assisted dying (VAD). The first article can be found here.