Reverend Steven Foster:

The Methodist Church in Ireland, through the Council on Social Responsibility, which I co-chair, has outlined its detailed position on physician-assisted suicide in its paper of 2013. In October 2020, we articulated our concern in regard to the then proposed Dying with Dignity Bill. Primarily, our concern is that all in society should be able to thrive. In the reality of the human experience of suffering, we want to see all supports and resources possible being provided for those with illness and-or disability and the root causes of injustice addressed.

To die with dignity touches upon our pastoral heart. We hate to see anyone suffering. We recognise the aspiration of those who would wish to see an end to their own suffering or of those around them. There are many heartbreaking circumstances for those who may wish for this. We are committed to compassion for those who are suffering and are passionate about human dignity.

At the heart of this discussion are the variations of human experience of life. We hold the journeys and experiences of those who have suffered most with great care. Marie Fleming, Brendan Clarke, from whom the committee has heard, and others have enabled us to gain deeper understanding of the suffering involved. We are thankful for their willingness to share their lives with us for our better understanding, even in the face of intense personal challenge.

We have a particular regard and concern for those who are the most vulnerable in society. This is at the core of our thinking on various matters. Those who are suffering terminal illness are certainly in a vulnerable state. This principle is primarily at work in us being against the introduction of an assistance in dying Bill, and the following is a summary of some of our specific concerns.

In such a setting, the management of a patient would in some way at least include the awareness of assistance in dying as an option. This affects the feeling of worth of those involved and could be interpreted as a duty to die. To allow choice can effectively encourage choice. No one should be made to feel a burden to society.

Assistance in dying undermines our societal efforts and commitment to saving life. This has particular resonance in regard to the prevalence of suicide. The clear message as a society that we need to be sending out to people is that we are interested in them having all the means necessary for good mental health and social health and opportunities to thrive. Public discussion on this underlines the need for renewed investment in palliative care, screening and mental health support services. We are concerned that, if assistance in dying were introduced, it would undermine the need for excellence in palliative care and its resourcing.

Conscientious objection would have to be a part of any potential legislation. However, it is still possible that a physician would be required to highlight its availability. If assisted dying is to be introduced, it is crucial that its option only be introduced at the request of the patient so as not to influence vulnerable patients. Crucially, an availability of assistance in dying changes the doctor-patient relationship.

While this meeting is not specifically about the Dying with Dignity Bill 2015, it rightly described a terminally ill person, which was a qualification in that Bill, 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 relating thereto". However, we are concerned that such a Bill would lead to confusion over the nature of where we should intervene. Given the severe suffering involved in chronic mental illness, other non-life-limiting illnesses and certain disabilities, would a line be crossed that would be difficult to define afterwards? The introduction of assisted dying would open up more questions. The public discussion and Bills are seeking to address real experiences of suffering. However, our society is full of suffering in many circumstances. If assistance in dying were made law for those with irreversible, incurable and progressive illnesses, it seems to us that others would regard themselves as having the same right to die as those to whom any such law was addressed, for example, someone who was suffering severe and intractable mental illness but who was not physically unwell or terminally ill. This would raise further questions for the future and could leave us as a society, as well as the medical profession, more uncertain about the sanctity of life.