Last October, the Dáil voted to initiate legislation to legalise assisted suicide and normalise euthanasia in Ireland. Shorn of language that might spook many TDs and cause voters to recoil, the Private Members Bill was sponsored by the radical left-wing People Before Profit/Solidary alliance. The vote was taken late in the evening, mid-week, and amidst a welter of procedural confusion, ethical reservations, political miscalculation and a failure of leadership by Fianna Fail.
The advice of healthcare specialists and representative bodies, particularly those working in palliative care and engaging daily with end-of-life care, is to reject the Bill. It seemed initially that, as a Private Members Bill with manifest flaws and anomalies, it stood little chance of progressing. However, this sanguine view underestimated the multiple ways in which political agendas can be progressed in contemporary Ireland.
The proposed legislation has now been rejected by the Oireachtas Justice Committee, but the issue is expected to return, and TDs and mainstream political parties – especially Fianna Fáil – need to address how, in the words of one political editor: “A truly seismic decision by Dáil Eireann…[was] passed by without sufficient attention…a new front- line in Irelands ever-evolving social agenda”. Read that last bit again “…ever-evolving social agenda”. The madness will not stop; it never does in revolutionary politics.
Language matters. The language in which so-called ‘progressive’ legislation is embedded in our society is typically that of ‘spin’: avoid stating the truth, choose your euphemism carefully, and base it on emotional appeal to those who will not read the fine print nor consider the longer-term consequences. We’ve seen this before.
TDs mindful of the legal, ethical and societal dangers of Assisted Suicide will likely not have to wait long to reflect on what may be one of the most far-reaching decision of their time in office. Waiting to be told to toe ‘the Party line’ and have one’s conscience assuaged on another Bill is an egregious form of political cowardice. The TDs who decided to ignore specialist medical advice and progress the Bill to Committee stage in the first instance have a case to answer given that it was found to be seriously flawed and lack safeguards. They could, of course, set aside socially progressive myth and spin, take their courage in their hands and pull back from a bleak legislative misadventure. Instead, the focus should be on how best end-of-life care can be enhanced and resourced and how the work already being done in suicide prevention can be further reinforced.
There is a political, as well as a medical, dimension to this challenge. We have to ask what kind of society our politics is forming where families are under the cosh, young people tempted to respond to emotional anguish and a lack of hope by suicide, and older people feel they are a burden, instead of grace, to increasingly fragmented families. As for medical ethics, an ideology that advocates the medical/nursing and allied professions accommodate to ‘progressive’ politics is advocating an ethos that has lost its way and its calling.
It is distressing to see how far Fianna Fáil, in particular, has come in ditching the life-affirming values that once shaped its health and social care policies. They are in grave danger of being displaced by Marxist politics rooted in Trotskyism. Many grass-root members know this to be the case – so do some TDs. Suppose Fianna Fáil cannot guide their membership, let alone the country, on this pivotal issue. Where can the politically exiled and disenfranchised look for guidance?
Some excellent submissions were made to the Joint Justice Committee, which did comprehensively reject the Bill. Notwithstanding these, three articles in the current issue of Studies, one of Ireland’s oldest and most respected Reviews, are exceptional in the insights they offer to politicians and the rest of us. They engage with great clarity and insight into the flaws, anomalies, conflicts and consequences of enacting the “Dying with Dignity Bill 2020” – a euphemism opaque to the realities of assisted suicide and euthanasia. Each of these articles is marked by an acute sensitivity to these most painful of issues.
They reflect on the facts, truth and consequences of assisted suicide and euthanasia. In “Assisted Suicide, Euthanasia and the ‘Dying with Dignity Bill 2020’ ”, Dr Noreen O’Carroll provides a rigorous evidence-based analysis that lays bare the misconceptions and the internal conflicts in the proposed legislation. In “The proposed Assisted Suicide/Euthanasia legislation” Professor Vincent Twomey writes with authentic compassion and experience of the consequences for contemporary Ireland and future generations of the Bill. Dr Gerry O’Hanlon SJ provides a deeply reflective and far-seeing perspective on “Human Suffering and Human Dignity”. Suffering is the great human enigma woven into all of our lives. At the heart of Christianity, and of the medical and nursing professions, is the question of how can suffering be healed, mitigated, and shared. Dr O’Hanlon and Dr O’Carroll question often unchallenged assumptions around the issue of assisted dying. The former argues that human dignity is not necessarily incompatible with suffering and pain, even when that pain and suffering is involuntary. While accepting and embracing unwanted suffering in either oneself or others is deeply challenging, it is inherently redemptive – a necessary means of recognising and responding to the dignity intrinsic to every person.
TDs need to allow themselves time to reflect on and pray about the insights embedded in these articles; they won’t find them in ‘Speaking Notes’ provided by Party HQs. But they reach out to those who are fearful, who may presently feel hopeless, and who are vulnerable to societal pressures of one kind or another that undermine their self-worth and the significance and value of their ‘being here’. They engage respectfully with differing views, accepting the personal integrity of the proponents of the Bill while setting out a deeper and more grounded truth.
Every one of us, and the next generation, would be deeply impacted by the flawed argument that legitimising the extinguishing life is an appropriate response to suffering. At an even deeper level, they engage with the zeitgeist of our age, obsessed as it is with ‘choice’ – the silo of secularism blind to the eternal and the assertion that life is ‘ours’ to dispose of and terminate, as and when we chose.
There are flaws hardwired into the Bill – even in the title. The truth is that dependence on others for care and support, be it in a hospital bed or a chair in the kitchen corner, does not offend against our autonomy or dignity. We are all bound together by mutual reliance; that’s what ‘community’ is about. It’s a nursery for learning about life and our responsibility to ‘the other’ while living out our time here on earth. You can glimpse this in the vision of a woman like Mary Aikenhead, who established Our Lady’s Hospice in Harold’s Cross. You witness it in the work of nursing and medical professions as they go about their work–and in those who serve the terminally ill through famine, plague, and war. It is a curious thing, therefore, that Christianity which proclaims our inherent dignity, not displaced by the human frailties which are part of who we are, gets such bad press. Compare this, for example, with atheistic marxism, which envisages no such dignity and regards the individual as a disposable economic cypher among the proletariat – or the ‘here today, gone tomorrow’ status under militant secularism.
Surely we would wish to be valued for all that we are and all that we hope to be with God after death? Surely we should respect a form of politics that puts the highest value on all of our lives, at every single stage of our lives and, by extension, the lives of others? The intrinsic dignity of every individual is at the heart of Christianity. It is not diminished by suffering, attended by the service of others.
The intentional extinguishing of a life is a terrible loss at every level. The bill seeking to legalise assisted suicide, and we’ve seen this before too, attempts to harness physicians and nursing professionals (with no effective conscience objection) to that end, notwithstanding that their vocation is to uphold life and to mitigate suffering with all of the resources of modern medicine. The consequence would eat away at the foundational ethos of medicine on which all of us will, one day, depend and, also, cast a utilitarian shadow over the formation of future trainees. Preserving that ethos as something very special is the responsibility of every TD.
Suicide is a truly awful social reality. Empathise as we may, it is impossible to put ourselves into the mind of the person who may feel impelled to consider ending their lives. For the person themselves, especially young people, it is impossible to comprehend the finality of death and the aching sense of loss of those who remain. It is why, after long years, Ireland have a national suicide prevention strategy. The bill would have normalised suicide, by sending ‘mixed signals’, vindicating suicide as a socially acceptable option. Where is the sense in that? As for euthanasia, history alone should make us recoil.
More generally, the Bill pivoted on the assumption that the particular circumstances of individuals, however grounded in personal integrity, should take precedence over the objective Public Good. Not so. The reality is that there are no silos that protect society as a whole – from the young and vulnerable to the old and dependent – from the systemic effects of such legislation. Professor Nigel Bigger has made the point that the slippery slope is very, very real. There will be the talk of ‘safeguards’ and ‘protocols’. They count for little. The so-called ‘Principled Pragmatists’ who drive ‘progressive’ legislation across the EU and in other countries know that well. There is not a TD in Leinster House who doesn’t know it either. Break open a hole in the wall first, then you can widen it. An ever-broadening cohort of people are vulnerable to irresistible political pressures to dilute safeguards on faux-compassionate, and then ideological, grounds. Legislation that reflects ideological capture will continue to be extended on the basis of putative ‘rights’ and, as night follows day, on social and then political grounds. The evidence is all around us.
The Bill would have subverted the medical, nursing, and allied professions to their core by making them instruments of state policies and commercial pressures. That is, by coercion – imposing on them the task of directly and/or indirectly facilitating the extinguishing of life. The societal consequences which are, in reality, the very antithesis of ‘progressive’, are unfathomable, beginning with a long-term loss of trust in our institutions. Some EU countries already empower young adults to take their own lives. This is deeply pernicious. To assert, as no doubt some may, that this will not happen in Ireland is, at best, naive. Add to this the evidence of widespread depression among young people associated, in part, with Covid. Consider also how the ideological forces that have captured our politics are spinning a web of anti-science fantasy in our schools and in the Public Square while pushing the reality of God to the margins. The dissonance in Irish politics is deafening, and it is impelling our society to a kind of madness where a default policy response to illness and what is socially deemed ‘abnormality’ is to extinguish life. This is nihilist.
The bottom line is this: the training and mission of the medical, nursing and allied professions is precisely to ensure that every person does, indeed, die with dignity – because each and every one of us is unique and unrepeatable. Palliative, including pastoral, care is a specialism deeply versed in all aspects of this mission. Those who have been privileged to see how such specialists engage with individuals, and their families, as some of us have, have an insight into an authentic understanding of dignity and compassion.
To go further down the road of regarding life as being contingent on ‘my choice’ – to live or terminate – is to deflect away from the relational nature of our lives. To ignore how this Bill would diminish the value of life, especially those who are vulnerable, would be wilful. Christians, in particular, cannot ‘sentimentalise’ away from the lessons of Christ’s suffering and acceptance of death as the segue to eternal life, as if it is something incidental rather than what gives life and death its definitive value. To turn away from the damage which would befall the healthcare professions now and into the future from this legislation is a terrible form of political blindness.
The Bill was deeply misconceived. Extinguishing life as a policy response is hardly shocking in the calculus of Marxist ideology. But it is wholly unworthy of a society, still less a Christian society, where every life is affirmed and valued. Existing efforts to deal with the underlying causes of suicide need to be reinforced, and the priority of government should be to consult with medical and nursing specialists in palliative care to address to strengthen end-of-life care. Leinster House needs a politics of Hope, Light and Trust.