Oireachtas Joint and Select Committees

Tuesday, 24 October 2023

Joint Oireachtas Committee on Assisted Dying

Assisted Dying and the Ethics of Autonomy: Discussion

Mr. Lloyd Riley:

I thank the Deputy for the questions. With regard to autonomy, it is important to see that the question of assisted dying does not exist in a vacuum. If we look at end-of-life practices across the board, we see that people can already make autonomous decisions that will result in their deaths. They can refuse potentially life-saving treatment or to have such treatment withdrawn. They can also stop eating and drinking, ending their lives in that way, often with the support of a clinician who provides sedatives and pain relief. There are therefore already ethically complex questions involved in end-of-life care. It is important to recognise that assisted dying would sit alongside that. We can learn a lot of lessons. Those decisions are safeguarded. How do we know that somebody is not being pressured into refusing chemotherapy? If people are already travelling to Switzerland for an assisted death or taking matters into their own hands under the law as it stands, how do we know what social message that is sending to potentially vulnerable people? This must be looked at as a whole. The countries that have legalised assisted dying have shown that.

If one looks at the committee in Victoria, the first Australian state to legalise assisted dying, it was very clear that it did not think the dangers in the existing legal framework could be justified. It recognised that the evidence from overseas showed that putting in place the safeguards of legislation is much safer for potentially vulnerable people. That is how to mitigate harm and look at autonomous decisions within a broader context.