Irish psychiatrists have outlined their strong opposition to assisted suicide and euthanasia ahead of another attempt to legalise the practices early next year.
In a position paper, the College of Psychiatrists of Ireland, which represents 1,000 doctors, warned that assisted suicide is incompatible with good medical care and asserted that a dignified death is possible with good palliative care.
The misleadingly named Dignity in Dying Bill has already passed the first two stages in the Dáil and is set to be considered by an Oireachtas committee in the new year.
‘Vulnerable people at risk’
The psychiatrists outlined their opposition to legalisation, saying: “Assisted dying is contrary to the efforts of psychiatrists, other mental health staff and the public to prevent deaths by suicide.
“It is likely to place vulnerable people at risk – many requests for assisted dying stem from issues such as fear of being a burden or fear of death rather than from intractable pain. Improvements in existing services should be deployed to manage these issues.”
They explained that, despite legislators’ attempts to define the law narrowly, “once introduced assisted dying is likely to be applied more broadly to other groups, such that the numbers undertaking the procedure grow considerably above expectations”.
There is stark international evidence of this ‘slippery slope’ from the Netherlands, Belgium, Canada and the US state of Oregon.
Dr Eric Kelleher, one of the paper’s authors, said: “We are acutely aware of the sensitivity of this subject, and understand and support the fact that dying with dignity is the goal of all end-of-life care. Strengthening our palliative care and social support networks makes this possible.
“Not only is assisted dying or euthanasia not necessary for a dignified death, but techniques used to bring about death can themselves result in considerable and protracted suffering.
“Where assisted dying is available, many requests stem, not from intractable pain, but from such causes as fear, depression, loneliness, and the wish not to burden carers. With adequate resources, including psychiatric care, psychological care, palliative medicine, pain services, and social supports, good end-of-life care is possible”.
‘Progressively broadening criteria’
Co-author Dr Siobhan MacHale added: “Once permitted in a jurisdiction, experience has shown that more and more people die from assisted dying.
“This is usually the result of progressively broadening criteria through legal challenges because, if a right to assisted dying is conceded, there is no logical reason to restrict this to those with a terminal illness.”