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Submission of CVI to the Oireachtas Committee on Justice regarding the Dying with Dignity Bill

Executive Summary

Despite euphemistic language about dying with dignity, the Bill before the Committee seeks to legalise doctor assisted suicide in Ireland. As Christian pastors and leaders, we oppose doctor assisted suicide for the same reasons we oppose suicide. We uphold the sanctity of mortal life and our duty as God’s image-bearers to protect life at all ages and stage. We also uphold the debt of love and duty of care we owe our neighbour to accompany those dying naturally with compassion and dignity in palliative care, which has the person and their family at its heart.


This submission points to the dangerous limitations in Mr Kenny's Bill, which fails to offer any safeguards to protect vulnerable people and shows insufficient regard for the conscience rights of doctors.


Christian pastors, like palliative care experts, are overwhelmingly opposed to assisted suicide; good palliative care already supports dying with dignity in Ireland. Legalising assisted suicide would endanger those who are sick, vulnerable, elderly and living with a disability by undermining the value of their lives. Giving assisted suicide approval in law contradicts, confuses and undermines anti-suicide messaging. Finally, evidence from other jurisdictions shows how rates of assisted suicide rapidly increase once legalised.


We urge the Committee to reject this Bill and promote palliative care in its place.



Issues with the Bill


The term "terminally ill" is very broadly defined without reference to the end of life.


To avail of assisted suicide, the Bill requires that a person be ‘terminally ill’, defined as “having an incurable and progressive illness which cannot be reversed by treatment, and the person is likely to die as a result of that illness or complications” (Section 8a). There is no list of eligible conditions. Such a broad definition could include people suffering with incurable and progressive diseases such as Parkinson’s, heart disease, dementia, cancer and many other conditions. These people can live for many years after diagnosis, and yet the Bill specifically excludes from the definition above “treatment which only relieves the symptoms of an inevitably progressive condition temporarily” (Section 8b). Thus, despite the use of the word ‘terminal’ many times, there is no requirement that the person be at the end of life to seek assisted suicide - once a diagnosis is received, the ending of one's life can be requested.



Relief of pain and suffering is nowhere mentioned in the Bill


Although advocacy for the Bill focuses on those who are experiencing “unbearable suffering”, the Bill contains no such requirement as a grounds for Assisted suicide. In fact, no reference is made to pain and suffering anywhere in the Bill. There is no requirement that the person be experiencing unbearable pain or suffering in order to seek a doctor to end their life. However, if loosening the definition of “unbearable suffering” has been linked to rising numbers of assisted suicides in the Netherlands since 2007, we can presume its absence in the Bill could lead to greater numbers of assisted suicides here.



The Bill makes no effort to protect vulnerable people from pressure to end their lives


The Bill makes almost no effort to include safeguards for vulnerable people. In fact, it specifies methods to promote understanding for those of limited capacity to make sure they consent (Section 10:3-4.) Yet the experience of other countries shows that vulnerable people feel under pressure to die by assisted suicide: it has been estimated that 1 in 5 patients who seek euthanasia in the Netherlands come under pressure to end their lives.



Conscience rights are not protected


Doctors would be obliged to refer patients for assisted suicide, striking down their right to conscientious objection (Section 13:3). In 2015, a survey by the Dutch doctors’ federation KNMG found that 70% of doctors feel under pressure to grant euthanasia, and 64% believed the pressure had increased in recent years.



Further reasons CVI rejects assisted suicide


We reject assisted suicide in favour of palliative care.


We respect the Bible, which is the foundation of human rights, responsibilities and protections in the legal systems of the West. Scripture points us to the sacredness of human life, as God’s image bearers, whatever our status, race or condition, and prohibits taking the life of another (Gen. 1:26-7; Ex. 20:13; Rom. 14:8; Gal. 3:28), as the Hippocratic oath also maintains.


In our view, dying with true dignity is already available in Ireland thanks to advances in palliative medicine and the meaningful spiritual support available in hospices, nursing homes and hospitals around the country. Holistic palliative care has the person and their family at its heart. As Christian pastors, we support a considered and compassionate approach to caring for, and proactively meeting the spiritual, psychological and physical needs and concerns of people approaching the end of their life, and we proactively warn against the dangers of assisted suicide, which is anything but respectful or compassionate.



We consider assisted suicide as not just a personal issue, but a societal issue.


While debates on assisted suicide are framed in terms of choice and autonomy, this ignores the impact an assisted suicide has on family, community and on society as a whole. As the COVID 19 pandemic has highlighted: “None of us lives for ourselves alone, and none of us dies for ourselves alone” (Rom 14:7). While we understand how suffering may lead an individual to long for death, evidence shows that legalising assisted suicide has a negative impact on all. We owe our suffering neighbour a debt of love (Rom 13:8) in the form of the best palliative care possible; at the same time, we must also show love to our neighbour by protecting the vulnerable from assisted suicide.



Once legalised, the number of assisted suicides rises rapidly


The number of assisted suicides in Switzerland has risen more than fourfold in little more than a decade, while Dutch authorities have recorded a threefold rise in euthanasia and assisted suicide since it was legalised in 2002. In 2019, euthanasia was the cause of death of 4.2% of the total number of people who died in the Netherlands.



Once legalised, the number of other suicides also increases


Globally, the rates of suicide are falling – by 29% since 2000, and much effort has rightly gone into suicide prevention in Ireland too. We recognise how challenges or mental illness can lead someone to want to die, but equally we do all we can to save lives to the extent that we prohibit press coverage which glorifies suicide to prevent copycat suicides.


Legalising assisted suicide has not reduced the number of total suicides as hoped; in fact, research contrasting the experiences of states in the U.S. found that legalizing assisted suicide “has been associated with an increased rate of total suicides”. Similarly, since euthanasia was legalised in the Netherlands, the number of other suicides has gone up - with a rise of almost 34% in less than a decade in contrast to surrounding countries without assisted suicide legislation.



Once legalised, restrictions are progressively loosened


Since 2014, Belgium has allowed children to be euthanized; and the euthanasia of children under 12 is also now permitted in the Netherlands. In 2019, the minister of health was considering a free suicide pill for over 70s, who were ‘tired of life’, which would be available via mobile euthanasia units.



Once legalised, vulnerable people can come under pressure to end their lives.


It is now well established from the experience of other countries that vulnerable people feel under pressure to die by assisted suicide. In the Netherlands, it has been estimated that 1 in 5 patients who sought euthanasia come under pressure to end their lives.


Hence, disability groups are some of the strongest voices against assisted suicide. The Royal College of Physicians notes: “All major UK advocacy groups for disability have rejected assisted suicide.” Liz Carr, British actress and disability activist, has opposed Lord Falconer's Assisted Dying Bills, because: "I fear we’ve so devalued certain groups of people – ill people, disabled people, older people – that I don’t think it’s in their best interests to enshrine in law the right of doctors to kill certain people.



Doctors in Ireland oppose the legalisation of assisted suicide and call for support for palliative care instead.


We stand with the Royal College of Physicians in Ireland (RCPI), which states assisted suicide “is contrary to best medical practice.” It says advances in medicine and in palliative care mean that “nobody should be suffering either mentally or physically”, and that “in the worst cases, palliative sedation [is] available to address intractable physical pain”. The RCPI is also concerned that a move towards assisted suicide would result in a shift in focus away from the development and the delivery of palliative care services and cure, and that research into palliative care may be discouraged. This is despite its acknowledged benefits to the dying and their families, which we as Christian pastors and leaders in CVI wish to recommend to the Committee.