It’s time to talk about eu­thana­sia

The Irish Times - Tuesday - Health - - Front Page - Padraig O’Mo­rain

Nic and Trees Elder­horst were 91 years of age when they died by eu­thana­sia in Hol­land re­cently. He had suf­fered a stroke and she had been told she had de­men­tia. Ac­cord­ing to a re­port in De Gelder­lan­der, they did not want to live with­out each other. Nei­ther did ei­ther of them want to die alone. They had been mar­ried for 65 years.

The case did not spark de­bate in the Nether­lands, where eu­thana­sia is le­gal. Ac­cord­ing to the Wash­ing­ton Post, the Dutch As­so­ci­a­tion for a Vol­un­tary End of Life, to which they be­longed, has 165,000 mem­bers.

I should add that this wasn’t just a mat­ter of de­cid­ing they wanted to die to­gether and get­ting on with it. Each had to meet the cri­te­ria for eu­thana­sia which in­clude be­ing able to give full con­sid­er­a­tion to what they were plan­ning to do, and that their suf­fer­ing was per­ma­nent and in­tol­er­a­ble. Had they not both met the cri­te­ria, then they could not both have legally been as­sisted to die to­gether.

Here we have not re­ally had any de­bate on the is­sue. Peo­ple say things to their fam­i­lies like, “If I ever get to be like that, shoot me,” which hardly counts as a de­bate.

In the 1990s, a GP called Paddy Leahy spoke openly about his pro­vi­sion of eu­thana­sia for peo­ple who were in pain with no hope of re­cov­ery. Even that did not lead to any sub­stan­tial pub­lic de­bate. Nei­ther did he face any le­gal con­se­quences – un­less he was pre­pared to name the peo­ple whose lives he had helped to end, an at­tempt to pros­e­cute would, I sus­pect, have been point­less. He was also a sea­soned old cam­paigner and a tough op­po­nent – I can re­mem­ber him fight­ing for the le­gal­i­sa­tion of con­tra­cep­tion and be­ing en­tirely un­fazed by a howl­ing crowd of op­po­nents at a meet­ing in the Man­sion House.

Health is­sues

Later, when he told the na­tion on Vin­cent Browne’s ra­dio pro­gramme that he in­tended to end his own life due to health is­sues, it all be­came more of a hu­man in­ter­est story than a de­bate over eu­thana­sia. Al­though I was in touch with him a good deal for The Irish Times in his fi­nal months, I am un­sure as to whether he ac­tu­ally ended his own life.

I re­call get­ting a let­ter at the time from a re­tired jour­nal­ist who told me he and his wife had al­ready made the ar­range­ments for eu­thana­sia. Again, I don’t know what hap­pened in the end. But the idea – and prac­tice – of end­ing your life be­cause of pain or health is­sues is noth­ing new in Ire­land. Pain and poor health have been iden­ti­fied as fac­tors in sui­cide among older peo­ple here and abroad.

In­tol­er­a­ble and in­cur­able

I be­lieve in the pro­vi­sion of physi­cian-as­sisted sui­cide for peo­ple whose suf­fer­ing is in­tol­er­a­ble and in­cur­able. It couldn’t be an op­tion in all such cases though – many, maybe most, of those who are suf­fer­ing in this way are in no con­di­tion to give con­sid­er­a­tion and as­sent to their deaths and so could not ben­e­fit from eu­thana­sia.

Then there is the mat­ter of whether con­di­tions such as de­men­tia should qual­ify peo­ple for eu­thana­sia, even if con­sent was given while they were still of sound mind. What if it’s the fam­ily and not the per­son with de­men­tia who is suf­fer­ing?

The ques­tion of con­sent is a thorny one. Some fam­i­lies would gladly push for eu­thana­sia to get their hands on an in­her­i­tance. Oth­ers would be torn apart by the idea of a par­ent seek­ing to die or of this op­tion be­ing raised with a par­ent.

The de­tails of a law al­low­ing as­sisted sui­cide and per­mit­ting hos­pi­tals to pro­vide it openly would need care­ful and prob­a­bly lengthy de­bate.

So the op­tion of shar­ing a last word and a kiss and dy­ing hold­ing hands won’t ac­tu­ally be a re­al­is­tic one – as it was for the Elder­horsts – for a long time, if ever.

In­stead, a death of this kind is likely to be a furtive af­fair, hid­den from au­thor­i­ties and maybe from loved ones un­til af­ter the last mo­ment.

‘‘ Peo­ple say things to their fam­i­lies like, “If I ever get to be like that, shoot me,” which hardly counts as a de­bate

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