Palliative care doctors warn against permitting assisted suicide

An Oireachtas Committee is currently meeting to consider whether Ireland should permit assisted suicide for the terminally ill. A key player in the debate, namely the Irish Association for Palliative Care (IAPC), is opposed. There voice is especially important as palliative care doctors deal with patients nearing the end stages of their lives every day. If they are against assisted suicide, then we should listen carefully to their concerns.

In a new document, prepared with the committee meetings in mind, they warn about the progressive relaxation of safeguards in other countries.

The organisation says that it “does not support any change in the law in order to legalise euthanasia / physician assisted suicide (PAS). We acknowledge the suffering of those diagnosed with serious medical illnesses. Solutions lie in improving palliative care and social conditions, and addressing the reasons for euthanasia/PAS requests, rather than changing legal and medical practice to allow it. The IAPC endorses the importance of access to palliative care for all who need it.”

In its document, the IAPC stresses that patients have a right to make decisions about their treatments, and doctors are not obliged to initiate or persist with treatments that are disproportionately burdensome. Trust and good communication between patients and healthcare professionals are key elements in medical care, they say, but “the legalisation of euthanasia / PAS could lead to the erosion of trust between patient and doctor”.

A practice that results in the death of a patient is contrary to the most fundamental principle in medicine: avoiding harm. “Our focus should be on supporting people experiencing physical and existential distress, rather than seeking to end their lives”, the palliative doctors write.

This is a position commonly shared by doctors in Ireland. In 2021 many Irish medical organisations expressed public opposition to the far-left TD Gino Kenny’s “Dying with Dignity” Bill.

See some examples here.

The IAPC document warns about the risk of coercion or fear of being a burden to others in patients who request a lethal injection. “The ban on healthcare professionals shortening a person’s life protects those who feel they ought to die. It acts as a form of protection for vulnerable patients who may be basing their decision to die on confounding addressable factors, such as a sense of being burdensome or mental health conditions”, it says.

The position paper mentions Canada and the Benelux as examples of countries where the eligibility for “assisted dying” has progressively expanded. If procuring death is the solution to suffering, there is no logical reason why it shouldn’t be offered to those who suffer because of disability, long term health conditions, or lower socioeconomic status.

The IAPC concerns are confirmed by recent news. The Netherlands will soon lift their age restrictions and ”assisted death” will be made available to children, something that is already available in Belgium.

Quebec now has the highest euthanasia rate in the world, accounting for 7pc of all deaths in the province.

Now a new law will extend the “right to die” to patients with a “severe physical impairment resulting in a significant and persistent disability”. The condition doesn’t have to be terminal or even life threatening.

This means that people diagnosed with Alzheimer or dementia can request euthanasia. In Canada, from March 2024, euthanasia will be extended to people with severe psychiatric illness.

In a particularly morbid development, the new Quebec law will also allow assisted suicide or euthanasia in outdoor spaces, such public parks. Funeral homes and even some churches are already offering “assisted dying” services in their premises.

The Oireachtas Committee should listen to the palliative care doctors and, to avoid what is happening in Canada, strongly reject any temptation to allow the same here.