Michael Clifford: Who wouldn't want to die with dignity?

The Dying with Dignity bill contains the last big question to be answered in the moral/human rights area since the country emerged from the authoritarian grip exercised by the partnership of Church and State.

Tom Curran, Vicky Phelan Gino Kenny, and Gail O’Rorke at the launch of Dying with Dignity bill. In 2015, Ms O'Rorke went on trial, charged with assist her friend Bernadette Forde to take her own life. She had acted out of love and was found not guilty. Picture: Gareth Chaney/Collins

Who wouldn’t want to die with dignity? Who would want to devalue living with a disability or the capacity to find reason or contentment as the light fades?

Those are the big questions in the debate that must follow the introduction of a Dying with Dignity bill this week. The bill was presented to the Dáil by People Before Profit TD Gino Kenny on Thursday. It proposes strict conditions in a law to allow a person take their own life if suffering from a terminal condition.

This bill has been a long time coming. The issue over choice in the ending of a life when one is either in pain, or in fear of the loss of dignity, is horrendously difficult.

It’s the last big question to be answered in the moral/human rights area since the country emerged from the authoritarian grip exercised by the partnership of Church and State.

First there was divorce, which required two bites of the cherry. (Yes, young readers, there was a time not so long ago that one could not fully exit a marriage irrespective of the state of a relationship.) This was rejected by the electorate in 1986 and narrowly passed in 1995.

Roll on to 2015 and the marriage equality referendum which was comfortably passed, and then there was the really big one, repeal of the Eighth in 2018, which had been a running sore for decades. Again, this was passed comfortably.

During every one of these campaigns for change those advocating the status quo resorted to major scare tactics. The 1986 attempt to introduce divorce was defeated, to a large extent, by arguments that poverty, particularly in the form of divided and uneconomic farms, would be a serious unintended consequence.

In 1995, the emphasis was on men leaving marriages and their children in droves. “Hello divorce, goodbye daddy” was the notorious advert at the time.

For marriage equality the spectre of an explosion in surrogacy parenting in order to facilitate married gay couples was going to be the consequence.

Children being taken from their natural parents and “awarded” to gay couples was going to be the consequence.

Two years ago repealing the eighth would, we were told, lead to young mothers being put under intolerable pressure to have abortions.

During each of these campaigns propagating unintended consequences was a tactic designed to scare. It is difficult to accept that even the most ardent opponent of these changes actually believed this stuff.

How will Ireland approach this moral issue?

Now we come to perhaps the last of these moral issues, dying with dignity. Will the spectre of unintended consequences feature again as a scare tactic? Or is there really the prospect of intended consequences that require serious and sober consideration?

For my part I would welcome the choice of dying with dignity. Hopefully, the issue will never arise for me or a loved one, but if it does I would be grateful if that choice to be available. I believe that at this stage in the evolution of human and civil rights everybody should be entitled to have that level of autonomy and control about their own lives.

In 2015, I covered the trial of Gail O’Rorke in the Dublin Circuit Criminal Court. She was charged with attempting to assist her friend Bernadette Forde to take her own life. Ms Forde was suffering from a severe form of multiple sclerosis.

Ms O’Rorke had acted out of love. In court, she was sitting where on other days violent criminals or white-collar fraudsters sat. The law required that she be put through the stress of an eight-day trial, with the real prospect of a jail sentence if found guilty.

There was a surreal atmosphere in court, largely owing to the fact that many people considered the defendant to be the victim. Ms O’Rorke was found not guilty but the law remains on the statute books.

Now Gino Kenny is making the first moves towards real change. Unlike the other major issues considered over the last 25 years, this one will be decided in the Oireachtas, rather than by referendum. That puts it up to the politicians, which isn’t necessarily fair, either to them or the wider public.

Irrespective of the electoral method to be used in dealing with this matter it is imperative that a debate takes place among the wider public.

Some will be steadfastly opposed to any change. A cohort in that camp will base their decision on religious beliefs, others on the basis of their own personal moral benchmark. Among the considerable cohort in favour of change there will be those who have had personal experience of observing a loved one struggle and suffer at the end of life.

A consultant's view on the Dying with Dignity bill

And then there are others, and I include myself in this, who subscribe to the autonomy argument but genuinely fear for the unintended consequences.

A few weeks back consultant geriatrician Des O’Neill was a guest on the podcast advertised on this page. Like many of his colleagues he is opposed to Deputy Kenny’s bill or any similar piece of legislation.

He believes that such a move would devalue life and particularly the living to be done in the latter stages of life. He suggests, for instance, that anybody who believes a person suffering from dementia or other terminal conditions should have the right to die actually exposes prejudice.

“Prejudice against age and prejudice against dementia remain the last acceptable bastions of prejudice,” he told me on the podcast.

He believes there are limits to autonomy, as demonstrated by various laws that restrict human behaviour in the name of the common good.

Prof. O’Neill makes cogent arguments as to why opening a door  — even in the very restricted manner proposed by Gino Kenny — will result in devaluing life, and ultimately lead to pressure being applied, in some instances, to people who are made to feel they are a burden. There is also the issue of whether palliative care will be devalued accordingly.

Therein lie the dangers. The jurisdictions that currently have a right-to-die law have not been operational long enough to offer any patterns of evidence one way or the other.

All of which points to the need for a reasoned, fact-based debate to engage the public on this issue. I suspect many are in the camp where they want to be convinced that their instinct to proceed is correct, but they crave reassurance.

An opinion column is typically supposed to enunciate a firm opinion. On this occasion, I can only say I am in favour of, if not Deputy Kenny’s bill, then something similar. Definitely, maybe.