Matters of life and death herald new age

IN years to come, the last week may be looked back on as seminal. When economics dominates public discourse, the news was full of abortion, euthanasia and population forecasts. It was a glimpse of what the future might hold.

The publication of the Protection of Life During Pregnancy bill was fundamental. For people opposed to abortion in all circumstances, it heralds the introduction of abortion in this country. They are convinced that the suicide clause in the bill will lead to that Biblical Armageddon, ‘the opening of floodgates’.

It won’t in the short-term, but, as the decades roll by, circumstances might change to facilitate young women having abortions in this country, rather than being forced across the Irish Sea.

That wouldn’t represent the opening of floodgates, as much as merely diverting the flow of women from airports to clinics within the State.

That day is still a long way off. In the interim, it’s likely that the next stage in the evolution of this issue will be to address the plight of the victims of rape, and to address fatal foetal abnormalities.

Even that day is a long way off, if form is anything to go by.

For the pro-choice constituency, the Protection of Life During Pregnancy bill will be viewed as the point at which women’s rights and health were, for the first time, acknowledged as no longer subservient to the dictates of the dominant religion in the State.

So, no matter which side you’re on, last Tuesday was a landmark.

The next step must be to address a related issue — people who require assistance in reproducing.

Last week’s legislation followed hot on the heels of an expert group report, published last November. By contrast, an expert group reported on assisted human reproduction in 2005 and we are still awaiting legislation.

In the interim, the thousands of couples who suffer from fertility problems have had to grapple with a system that is unregulated, and, therefore, open to exploitation.

There has been much discussion lately on the trauma of an unwanted pregnancy. Equally, those who desperately want a pregnancy, but require assistance, can endure trauma that persists for years.

The reason for the inaction is the same reason that it took 21 years to grapple with the fall-out from the X case — politicians are afraid of igniting passions among those who believe that human life begins at conception.

The expert group report into assisted human reproduction said that, legally, life began at implantation. This view was endorsed by the High and Supreme courts, in the Roche case in 2009.

Yet, the fear of the stink that would be kicked up by the anti-abortion lobby has seen the body-politic run for cover. It’s an issue that needs to be addressed urgently.

Similarly, there is no legislation on embryonic stem-cell research, a strand of science that has made great strides towards tackling debilitating illnesses. We don’t have any law in our so-called knowledge economy that governs this research. The same fears apply in the body-politic. If it’s anything to do with the biological process, between conception and birth, just keep the head down.

The demand for the fruits of embryonic stem research are bound to increase in the coming decades, as life-expectancy increases, and with it the demands for a greater quality of life in the winter years.

The extent, and impact, of a changing demographic was presented last week in a CSO report on Ireland’s burgeoning population.

By 2046, the State’s population is projected to be 6.7m. Life expectancy is expected to increase, from 77.9 years in 2010 to 85.1 years in 2046, for men, and from 82.7 years to 88.5 years for women. This will herald major changes in demographics. For instance, the number of 80-year-olds in 2011 was 128,000. This is expected to nearly quadruple, to 484,000, by 2046.

While the increase in population will present problems, it also has many benefits. Ireland still has the highest birthrates in Western Europe, at 2.1 per woman, and is expected to remain at that rate. As a result, this State will be slightly better-positioned to cope with a major fall in the ratio of those working to those retired.

At the beginning of the 20th century, the numbers working per retired was 22:1. Over the coming years, this will fall to 3:1, and down to 2:1 in some countries across Europe.

These challenges are being signalled when attitudes towards not just the creation of life, but the ending of it, are entering a different realm. Last Monday, the Supreme Court refused Marie Fleming’s appeal that she be entitled to assistance in ending her own life.

Ms Fleming is in the latter stages of MS, and the details of her condition and suffering made for heartbreaking reading.

Yet, the Supreme Court agreed with the High Court that to grant the request would be to open a “Pandora’s box”, as it was described by Judge Nicholas Kearns. The great fear is that any movement towards assisted suicide, or euthanasia, will leave elderly people open to the possibility of facing pressure to end their lives.

The Supreme Court did open the possibility of legislation being introduced to cater for cases like that of Marie Fleming. In keeping with a long-standing trend, the Government is likely to run a mile, but there’s only so long that heads can remain lodged in the sand.

The CSO report moves the end-of-life solution debate into a different context. With life-expectancy set to increase, a greater emphasis on quality of life among the elderly is likely to ensue.

In such an environment, people who are in serious pain or who are suffering from terminal conditions may be more forthright in wishing to end life on their own terms.

The other side of the argument has also received ballast from the CSO report. Retirement will last longer, in some instances as long as a working life.

People still in work will be under greater pressure to provide, particularly through taxes, for the huge cohort no longer working.

It’s easy to see how, in the society of the future, that pressure could be brought to bear on elderly people who have become a burden. The pressure could be subtle and would be applied behind closed doors, most likely in the home, beyond the reach of State vigilance.

It’s a frightening prospect, but not an outlandish one. Still, the status quo is not acceptable either, as the case of Marie Fleming demonstrates.

One way or the other, long after the economic clouds have packed up and left, these life issues are going to come increasingly to the fore. We had a glimpse of the future last week, and one thing that all sides can agree on is that it’s going to be complicated.