Oireachtas Joint and Select Committees

Wednesday, 22 November 2017

Joint Oireachtas Committee on Justice, Defence and Equality

Right to Die with Dignity: Discussion

9:30 am

Mr. Tom Curran:

I have a brief statement, after which I will be more than prepared to answer whatever questions members have.

Some people want to eke out every second of life, no matter how grim

And that is their right.

Some people don’t

And that should be their right.

That is a quote from the 1990s from the American journalist Betty Rolland after she was diagnosed with incurable cancer. To me, it sums up what the right to die is all about - it is about choice. It is about the ability to make decisions about one's own end-of-life situation to avoid a prolonged, painful and distressing death. It is commonly accepted that people have the right to live their life as they choose, provided they do not do anyone else harm; why, therefore, should a person not have the right to make decisions about the manner of their own death?

Most people I know who are involved in the right to die movement around the world are involved from personal experience. They have either witnessed someone they loved go through a bad death, or else they or someone they love are facing the prospect of a bad death. I am no exception to this rule. The person I loved, Marie, suffered from multiple sclerosis. Many years ago, when it moved from relapsing-remitting to progressive and she saw that it was taking more and more control of her life and her ability to live, she decided that it was not going to take control of her death. She knew that she faced the likelihood of a prolonged and, possibly, painful death and, being the strong willed person she was, was not prepared to let that happen. She did not want to die. Far from it, she wanted to live. She was never suicidal, but she did not want a bad death. When she explained to me what her wish was, it seemed like the most natural thing to want. It was only then that we discovered what she wanted would by no means be easy to achieve.

As I had done voluntary work in the area of suicide prevention for many years, I was aware that suicide had been decriminalised in Ireland in the early 1990s. This meant that taking her own life was not an issue. The problem was how to provide for a peaceful and painless death for oneself. Most of the irrational suicides that take place are performed in some horrific manner, but that would have completely defeated the purpose of what Marie wanted to achieve. That brings up the question of if it is legal for a rational person to take his or her own life, why is assisting a person to do something that is legal a crime and why is assistance necessary? I cannot answer the first question of why assisting someone to do something that is legal is a crime, but the second question of why assistance is required can be answered.

There are two basic reasons assistance is necessary. The first has to do with the method of providing a peaceful, painless death for oneself. That is not as easy as it may seem. There is almost nothing sold anywhere, either by prescription or over the counter, that will achieve that aim. Of course, there are many substances that will kill but not peacefully and painlessly. Any substance that will provide a peaceful and painless death is almost exclusively in the hands of those in the medical profession, but providing such a substance would be classified as assisting a suicide and, therefore, against the law.

The second reason is that in most cases the reason for making the decision to die is that the person is suffering from a progressive and, possibly, incurable disease which will eventually make it physical impossible for him or her to end his or her own life. In these circumstances denying a person access to something that is legal and available to any able-bodied person must amount to discrimination.

Let me try to explain why the right to die has recently become an issue around the world. The first reason is the advancement of medical science which has meant that in most parts of the world people are living to a much greater age than they could have imagined many years ago, but this brings its own problems. With living longer comes the likelihood that we will spend the final years of our lives suffering from a disabling illness which will usually mean that the final years of life will be far from comfortable. In addition, in the early to mid-20th century people started to think for themselves; the civil rights movement sprang up around the world and in many areas people were looking for personal freedoms, of which the right to die was one. People decided that death which used to be very much a family affair had become a medical procedure. This is borne out in Ireland where over 80% of people wish to die at home but less than 20% do. In fact, over 50% die in acute hospitals, in many cases in multiple-bed wards. This has made the process of dying clinical, not the celebration of life it used to be. This made people question why they had very little say in the way they would die and the right to die movement was born. It has resulted in a slow but progressive acceptance that rational people should have the decision-making power when it comes to deciding how they will die.

There have been the usual arguments against allowing a person to decide for himself or herself. They include religion, the danger posed to vulnerable persons and the co-operation of the medical profession.

These arguments are easily countered and this has been done in several parts of the world.

Getting back to the position in Ireland, the committee is probably aware that Ms Marie Fleming and I took a constitutional challenge to the law on assisted suicide. Some very interesting points were made in the summing up in the High Court. Let me outline a few of them here. Apart from stating that Marie was one on the most remarkable witnesses to ever come before the court, it upheld the fact that Marie was being discriminated against by her multiple sclerosis preventing her having access to something that any rational able-bodied person has. To right this wrong, the only option that the High Court has is to declare the law which allows this discrimination is unconstitutional and the law must be struck out. It is not in its powers to amend a law. The court stated that on a proportionality basis, it was not prepared to strike out the law, as without any law, vulnerable people would be open to abuse. I agree completely with this decision but it followed up by stating there is nothing preventing the Oireachtas from enacting a law that would allow for assisted dying for people like Marie and at the same time protect the vulnerable. None of the parties has had the courage to tackle this and the closest we have got is the presentation of a Private Members' Bill, drafted by me with the help of four barristers, and put before Parliament by Deputy John Halligan. This Bill has since been withdrawn so we are no closer to providing this civil right to people than we were then.

The other interesting point of come out of the High Court was the statement in the summing up that if the court could provide a law specifically for Marie, it would do so. This was an extraordinary statement. It felt that Marie satisfied whatever criteria seen as necessary to be allowed an assisted death. Marie was an exceptional person but there was nothing exceptional in what she was asking, and certainly nothing that would suggest that other people would not satisfy the same criteria. Why, therefore, have we still got the situation that if Marie can satisfy the highest court in Ireland that she should qualify for an assisted death, this right is still denied to others?

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