Dr. Regina McQuillan:

I will go through Deputy Daly's points but I may have missed some of them. They related to protecting vulnerable people, being a burden, devaluing life and what other countries have done. Unfortunately, what other countries have done has not been effective. That is very clear. Oregon is the US state which has had assisted suicide for the longest period and there is a gradual increase in the number of people who are dying by assisted suicide there. Interestingly, there is also an increased rate of suicide among the regular population. There is an argument as to whether allowing assisted suicide then means that suicide is more culturally acceptable. In Oregon the percentage of people who look for assisted suicide on the grounds of not wanting to be a burden has gradually increased over the years. One of the factors in assisted suicide there is fear of being a burden. Initially the legislation there was for people who had a prognosis of less than six months. It is clear that sometimes people get such prognoses but may live for many months if not years afterwards. There is a difficulty about the prognostication and how one knows how long somebody is going to live. In Oregon there was a call to extend the period of time from six to 12 months.

In the Netherlands, there probably are greater concerns because there is a long practice of allowing assisted suicide and euthanasia involving decriminalisation rather than legislation. There is an incidence of non-voluntary euthanasia in the Netherlands, as well as voluntary euthanasia, and there is also euthanasia of people with dementia who have not made advanced care plans. Those case reports exist in the Netherlands. It is clear that it is not possible to protect people there. Similarly in Belgium where there is legislation in respect of euthanasia, but again, that is extending so there is euthanasia for people with particular illnesses, but also people who are deaf or going blind have euthanasia, as well as those who are tired of life. Although many of those jurisdictions require that people are assessed and treated for depression, that does not always happen or does not always happen effectively. I do not think it is possible to protect people and that one will change society by introducing such legislation. One would change society in a number of ways. First, by saying that suicide is not such a concern to society as it currently is. We can campaign against suicide but if we say some suicides should be allowed then we are saying that suicide is not as much of a concern to society as it should be.

People who are living with disability live in very difficult times and in very difficult situations. In some situations assisted suicide or dying is promoted with regard to people who are terminally ill and people who have disability. This is a severe threat to people who are living with disability. Those can be people who have physical disability but it is more of a threat to those who do not have physical disability. I think allowing assisted suicide changes society.

Another way that allowing assisted suicide brings about a change is that it changes the idea of what health care is. Mr. Curran mentioned that doctors are the only people with access to medication. A very interesting paper was published about 20 years ago by an ethicist in the UK entitled Two lawyers and a technician. Her view was that assisted suicide and euthanasia should not be part of health care because it is not about care. It is something entirely different. Her argument was that there should be two lawyers looking at competency and a technician who is vocationally trained for this purpose. That was a different way to remove the idea of assisted suicide and euthanasia from health care. I do think this should never be part of health care. It is an undermining of what health care should be and is all about. I am not too sure whether I have covered all of Deputy Daly’s points.