The Oireachtas Committee on ‘assisted dying’ continues to hear expert testimony on the matter. Last week it heard from a Dutch academic who was once a supporter but has now turned into a critic. He spoke of how insurance companies in his country are already funding the procedure for one provider, which is a chilling possible glimpse of the future.
The Dutch expert, Theo Boer, who is a professor of healthcare ethics, said the legalisation of euthanasia in the Netherlands has turned our view of suffering, ageing and taking care upside down. The numbers are speeding up and the biggest increase is now in illnesses that are not terminal.
He was initially supportive of euthanasia legislation and now, having reviewed 4,000 cases on behalf of the Dutch government, has become critical of it.
He told the committee that in 20 years the numbers availing of it in his country have quadrupled and, in some neighbourhoods, medically assisted euthanasia account for 15pc to 20pc of all deaths. These figures are underestimated, he said, as a governmental evaluation has found that between 10pc and 15pc of doctors do not report their participation in the programme.
He noted that there has been an expansion in the reasons for euthanasia — from those at the end of a terminal illness, to people today fearing loneliness, alienation and care dependency. Once euthanasia is introduced, why should it be provided only for terminally-ill patients, or for those suffering from physical illness and pain, he asked. Sometimes it is the absence of hope that provokes the suffering, he said.
“That is why we have now a law in parliament that legalises euthanasia for all people over 74 years, with or without an illness. Their age is the only reason they can have assisted dying. That in turn is why we now have a regulation that allows parents to request euthanasia for their young children aged from zero to 11 years old. I am convinced it is only a matter of time before we take the next hurdle, namely, allowing children of dementia patients to request euthanasia for their demented parents”, he told the committee.
The second expert who spoke was Silvan Luley, representing Dignitas, a group that facilitates assisted suicide in Switzerland, where it has been legal since 1942. Currently, about 1,700 per year avail of it. He claimed that Dignitas has almost 100 Irish members and 12 people from Ireland have been helped to kill themselves by his organisation.
Dignitas offers assisted suicide not only to those who are terminally ill but also to anyone who has an “endurable incapacitating disability” or suffers ‘unbearable pain’. Mr. Luley told the committee that fewer than 50pc of those who avail of their assistance are terminal. He explained that they offer a professional alternative to violent suicides.
“It is about having an emergency exit door that provides emotional relief and can prevent people from using rough, violent do-it-yourself suicide methods. The people in Ireland should have what everyone deserves: a legal way to exercise the human right of freedom of choice on all options of professional care to soothe suffering and end life at their home” he said.
Luley was challenged by Prof Boer who referred to new studies presented at a congress of 250 psychiatrists he attended recently. One study found that since the Netherlands allowed euthanasia for reasons of psychiatry, dementia and long-term chronic illnesses, the number of violent suicides has risen against expectations by 35pc, while it went down by 10pc in neighbouring Germany.
Moreover, another new study showed that “in places where there is more euthanasia, there is also a slightly higher suicide rate. … It cannot be proven that if one provides euthanasia, it will bring the suicide numbers down”, according to Prof Boer.
(Previous research from the Anscombe Bioethics Centre found similar results https://ionainstitute.ie/assisted-suicide-does-not-reduce-overall-suicide-rate-says-new-study/)
Prof Boer said that there is a general societal pressure that makes feel the patients a burden to their families and to their country.
He also pointed out that in the Netherlands, one organisation, funded by insurance companies, offers euthanasia. The cost is €3,300, of which the performing physician receives €2,000. “For some of these physicians it is kind of a profit thing. I have heard several of them say that they need this money for several reasons, even though most of them are retired. However, it is officially not for profit. … they only offer euthanasia. They do not offer any other help. They do not offer psychiatric or social help. They can only refer the patient back to where they came from.”
The Swiss group Dignitas, which is also not-for-profit, charges the equivalent of about €11,500, plus VAT, for the complete service, which includes funeral and administrative costs.
As the population ages, and healthcare costs mount, it is easy to envisage insurance companies offering to pat their customers for euthanasia. Think of all the money they would save.