European Court of Human Rights rule

Irish, English and Welsh laws are very similar in relation to assisted suicide. Our Criminal Law (Suicide) Act 1993 is mirrored on the Suicide Act 1961 in England and Wales. Recently the UK issued guidelines for the prosecution of individuals who assist a suicide. These guidelines highlight the situations where the DPP is more likely to prosecute an individual[12]. The DPP in the UK was forced to produce these guidelines after the Purdy case[13]. In 2008 Debbie Purdy, who suffers from MS, won her case in the House of Lords against the British government.

She argued that she had a right to know what penalty her husband would face if he accompanied her to the Dignitas clinic in Switzerland. The court backed her request that the DPP should produce the factors that he would consider as relevant when deciding to prosecute a case of this kind. The DPP stated that they would look more to the motives of the assistant (similar to the Swiss law) than the condition of the victim and issued 11 situations where they would be more likely to prosecute.

These include situations where the victim is under 18 years of age and mentally incapable of making an informed decision about suicide. Where the victim didn’t ask for assistance or where there was pressure placed on them or when the assistant doesn’t make enquirers as to whether they are being pressured by someone else. Also where the assistant isn’t entirely motivated by wanting to end the victims suffering or where the assistant has a history of abusive or violent behaviour towards the victim or where the victim was incapable of carrying out the process by themselves due to their illness.

The DPP will also prosecute in situations where the victim did not know the assistant and were encouraged to commit suicide by the assistant or where an assistant gave information to more than one victim. This guideline suggests that the DPP would not prosecute the spouse or friend who travels with the ill individual to avail of assisted suicide but instead protects individuals from dangerous people who have motives other than wanting to end suffering. The guidelines say that they will also prosecute in situations where the assistant is paid by the victim or those close to the victim.

They will also prosecute where the victim was encouraged by a medical professional or any individual who was in charge of caring for them or if the assistant knew the victim was planning a public suicide where members of the public could see. With the introduction of these guidelines in the UK it will be interesting to see if Ireland will follow suit in the near future. In 2010 a Commission on Assisted Suicide was established in the UK to investigate the adequacy of current assisted suicide laws, in January 2012 they issued a report claiming the laws were insufficient[14].

They recommended that assisted suicide should be legalised when a person has less than a year to live, two doctors are satisfied with the diagnosis, the individual has been informed of all help available to them and where the doctors are satisfied that the individual has no mental illness that can impair their judgement on the decision. The report in the UK has prompted discussion on legalising assisted suicide in Ireland. Dr Adam McAuley, lecturer of Medical and International Human Rights at UCD has spoken out in support of the legalisation of assisted suicide in Ireland[15].

He says that provided steps are put in place to regulate it assisted suicide should be made available to those people who want it to relieve their suffering. In reality Irish people are availing of assisted suicide services abroad regardless of the fact that it is illegal in Ireland. The Government’s aim of preventing assisted suicide have been unsuccessful so perhaps the most rational thing to do in these circumstances is to legalise assisted suicide, at least then there would be regulations in place and some regulations are better than having none at all.

Assisted suicide is not murder it is an informed choice. It is very easy for healthy people to protest against assisted suicide and prolong an ill persons suffering but assisted suicide (motivated by wanting to end a loved one’s suffering) is not a crime like rape or murder. Assisted suicide is a cry for help where an individual asks for help to die and no third party is hurt in the process. It is a private decision to die with dignity which should be respected by society and regulated by law to prevent abuse. Proponents of legalising assisted suicide say that there are many reasons why it should be legalised.

In relation to human rights, we have a right to life and we have the right to enjoy it with at least a minimum amount of quality. Death is an important event in life, albeit the last and we have the right to try to make the events in our lives a good as possible. Forcing someone to stay alive against their wishes violates their right to autonomy and personal freedoms[16]. In 2002 the European Court of Human Rights ruled on the case of Pretty v United Kingdom[17]. Ms Diane Pretty suffered from motor neuron disease and wanted to end her life but was unable to due to her illness.

She wanted her husband to assist her and asked that the DPP would not prosecute him for doing so. She argued that article 2 of the European Convention on Human Rights (ECHR) gives a right to life but it also infers a right to death and that she has the right to privacy under article 8. The court found no violation of the convention and held that article 2 does not infer a right to death and that occasionally it was necessary to interfere with an individual’s right to privacy for the purpose of protecting the rights of others.

Opponents of legalising assisted suicide will say that section 2(2) of the Criminal Law (Suicide) Act 1993 makes it illegal to assist someone to kill themselves, but section 2(2) was more than likely aimed at preventing people murdering others by making it look like suicide. If this is the case then the UK guidelines for assisting a loved one to die should be introduced in Ireland. Davies argues that there is a vast difference between “rape” and “making love” but essentially that difference is consent on the part of the receiver.

Similarly the concept of “killing” is very different from the concept of “please help me die”[18]. If someone requests and consents to an assisted suicide should their wishes not be respected? The word “kill” implies violence and a non-consensual act being performed against the receiver, but assisted suicide is a kind and caring act[19]. A doctor must care for his patients and their wellbeing. Their main goal is to cure their patients but in some cases this is not possible. Doctors cannot “kill” their terminally ill patients even when it is requested yet assisting an individual to die can be viewed as the last act of care.

Many doctors in Holland and arguably, albeit secretly, doctors from other jurisdictions are in agreement with this view. We all must abide by the law. We can’t kill, rob or rape. Another example is that it is illegal to run through a red light when driving as it creates a danger to society yet there are certain professionals who are allowed. Police, fire brigades and ambulances are allowed break this rule. This is because it is more beneficial to society to allow those specifically trained professionals to break this rule than there is in not allowing them to do it[20].

This logic can be argued as a reason for allowing doctors to perform physician assisted suicide in this Ireland. They are trained professionals who have a duty to care for the sick but when no amount of care or medicine will cure the patient then ‘care’ should mean allowing them to die peacefully. An Irish poll in 2005 discovered that 53% of Irish people are in favour of legalising euthanasia in Ireland, 35% were against the idea and 12% were unsure on the matter[21]. This means that the majority of Irish people are in favour of allowing the legalisation of euthanasia so perhaps now is the time for a change.

Irish people are going abroad to avail of assisted suicide services and due to our current laws anyone who accompanies them are liable for up to 14 years imprisonment on their return for assisting the suicide. This means that Irish people suffering with terminal illnesses but who still have a certain level of quality of life and not yet completely dependent are traveling to Switzerland at an earlier than necessary stage of their illness to make use of assisted suicide services available there. This begs the question of which devalues life more?

The act of allowing an individual wishing to end their suffering in a peaceful manner surrounded by their family and friends to do so or making an individual, who can still enjoy a good quality of life for some time, leave home out of fear of future suffering and die alone while they are not completely dependent on others. Switzerland is not the only country to allow assisted suicide. The state of Oregon in America legalised physician assisted suicide in its Death with Dignity Act 1998 and the state of Washington followed suit.

Voluntary euthanasia and assisted suicide are illegal in the Netherlands but doctors are exempt from these laws in certain circumstances. Article 293 (2) of the Netherlands Criminal Code states that a doctor may permit a patient to avail of euthanasia or assisted suicide if he is satisfied that the patient has met certain criteria. The doctor must be satisfied that the patient has made this decision to end his life by himself and is not been influenced by any other reasons other than pain and suffering.

The patient must be currently enduring unbearable pain or will be enduring it in the near future. The doctor must explain the patient’s diagnosis to him and what the future will bring and together they must be convinced that there is no other alternative other than euthanasia or assisted suicide. A second doctor who has seen the patient previously must also be consulted. Only then can the doctor help the patient to end his life. Euthanasia has been legal in Belgium since 2002. Similarly Luxemburg followed suit in 2008 and made euthanasia and assisted suicide legal.

The UK guidelines on assisted suicide urge prosecutors to avoid prosecuting individuals who help friends or family members to die out of compassion and without pressure. There are no such guidelines in Ireland. We live in a democratic society where the majority of people believe in legalising assisted suicide yet it is the views of the minority that is the law. A recent survey of 170 final year medical students in University College Cork showed that 58% of them were in favour of legalising physician assisted suicide. This shows the changing attitude of medical professionals in this country.

Physician assisted or any kind of assisted suicide is illegal in Ireland but passive euthanasia is legal. A patient can choose to end life support and in certain cases the family members of an ill person can make applications to the courts to have life support removed. This was seen in the RE a ward of court case no 2[22]. In this case a woman had suffered complications due to surgery and was left in an almost completely vegetative state. Twenty years after the surgery the family sought to have her life support treatment removed.

The Supreme Court upheld the High Court’s decision and consented to the life support being removed. This essay has discussed the law on assisted suicide in Ireland, Switzerland and the UK. I believe that assisted suicide should be made a choice for people with an illness who want it or at the very least the same guidelines that were introduced in the UK should be introduced here. The reality is that Irish people are availing of these services in Switzerland yet the majority of Irish citizens are in favour of legalisation.

Ireland is a country that has changed immensely in the last 20 years. One of the biggest changes is the separation between the state and church. The people are realising that the churches morals should not necessarily be their own. In the last two decades we have seen the introduction of the Family Law (Divorce) Act 1996, exceptions to the abortion laws and under the 1993 Act suicide is no longer an offence. Assisted suicide is an area of law which I believe will be getting more attention in coming years and perhaps even a referendum on its legalisation.