The Joint Committee on Assisted Dying [Assisted Suicide / Euthanasia] has just released their final report.
Below are the 38 Recommendations — verbatim.
(To read the full report please click on the image to the right, or follow the link.)
Recommendation 1
The Committee recommends that the Government introduces legislation allowing for assisted dying, in certain restricted circumstances as set out in the recommendations in this report.
Recommendation 2
The Committee recommends that any legislation for assisted dying may entail amendments to the Criminal Law Suicide Act 1993.
Recommendation 3
This Committee recommends that where any person has failed to adhere to relevant statutory requirements governing assisted dying, he or she will have committed a criminal offence.
Recommendation 4
The Committee recommends that any potential legislation on assisted dying provides that where a person has been proven guilty of coercion, they will have committed an offence under the Act.
Recommendation 5
The Committee recommends that doctors and healthcare workers involved in the provision of assisted dying be trained to the highest level possible to identify coercion when assessing or treating a patient.
Recommendation 6
The Committee recommends that if a medical professional has been proven to have acted outside of the permitted regulations or has attempted to coerce an individual, they will have committed an offence under the potential legislation and may be held liable.
Recommendation 7
The Committee recommends the inclusion in any legislation on assisted dying of mandatory reporting to An Garda Síochána of any information or evidence concerning the issue of possible coercion in relation to assisted dying.
Recommendation 8
The Committee recommends that where capacity is in doubt, a functional test for decision-making capacity should be part of the assessment for eligibility for assisted dying.
Recommendation 9
The Committee recommends that any doctor involved in determining eligibility for assisted dying must have professional training in assessing capacity and voluntariness.
Recommendation 10
The Committee recommends that following an initial successful assessment for assisted dying that finds a patient eligible, if the patient temporarily loses decisionmaking capacity, then that eligibility is suspended for the duration of their incapacity.
Recommendation 11
The Committee does not recommend that advanced healthcare directives allow for individuals to make requests for assisted dying. However, consideration of the issue may be included in any review of assisted dying legislation.
Recommendation 12
The Committee recommends that the updated palliative care strategy should be published by the Department of Health without delay.
Recommendation 13
The Committee recommends that palliative care and the operation of assisted dying should operate completely separately and independently of each other.
Recommendation 14
The Committee recommends that resources and funding for, and information about, palliative care services should be substantially increased, to ensure consistent and accessible services of the highest quality are provided throughout the country.
Recommendation 15
The Committee recommends that funding for assisted dying and palliative care be separate and distinct from one another, provided for in separate votes in the Department of Health budget.
Recommendation 16
The Committee recommends that a person inquiring about assisted dying, following a terminal diagnosis, should be informed of, and assisted in, accessing all end-of-life care options, including palliative care.
Recommendation 17
The Committee recommends that the right to conscientious objection of all doctors and health workers directly involved in the provision of assisted dying should be protected in law. Notwithstanding the above, the Committee recommends that when a doctor or health care professional exercise this right, that this will not have the effect of closing off access to assisted dying to the patient. To this end, the law should place a requirement on a health care professional, who refuses to participate in the service, to refer onwards to a participating health care professionals and/or a national oversight body.
Recommendation 18
The Committee recommends that any doctor or health care workers opting into the provision of assisted dying, be provided with enhanced training and support, including funded access to international peer support networks.
Recommendation 19
This Committee recommends that any potential legislation on assisted dying uses clear and unambiguous terms and definitions, to avoid scope for uncertainty.
Recommendation 20
The Committee recommends that informal carers are robustly supported in their caring duties, with additional resources provided to include funding, counselling and respite provision.
Recommendation 21
The Committee recommends the need for much increased mental health supports to help identify and respond to mental health issues, especially age-related mental health challenges, and for mental health supports to always be made available to those receiving a terminal diagnosis.
Recommendation 22
The Committee recommends that research be carried out on the relationship between economic disadvantage and health inequalities, and the question of people feeling a burden.
Recommendation 23
The Committee recommends that the Optional Protocol to the United Nations Convention on the Rights of Persons with Disabilities should be ratified as a precondition of the commencement of assisted dying legislation.
Recommendation 24
The Committee recommends that if assisted dying is introduced, an assessment by a qualified psychiatrist should be required in circumstances where the patient is deemed eligible but there are concerns about whether the person is competent to make an informed decision.
Recommendation 25
The Committee recommends that eligibility for assisted dying should be limited to Irish citizens or those ordinarily resident in the State for a period of not less than twelve months.
Recommendation 26
The Committee recommends that assisted dying should be limited to people aged 18 or over.
Recommendation 27
The Committee recommends that only a person diagnosed with a disease, illness or medical condition that is:
a) both incurable and irreversible;
b) advanced, progressive and will cause death;
c) expected to cause death within six months (or, in the case of a person with a neuro-degenerative disease, illness or condition, within 12 months); and
d) causing suffering to the person that cannot be relieved in a manner that the person finds tolerable, is eligible to be assessed for assisted dying.
Recommendation 28
The Committee recommends that two formal requests for assisted dying must be made, with a set specified interval between. At least one of these requests must be recorded in writing, and before two independent witnesses.
Recommendation 29
The Committee recommends that any potential legislation for assisted dying should establish a national body with sole responsibility for assisted dying services and related supports.
Recommendation 30
The Committee recommends that the national body for assisted dying should be independent of the other state bodies.
Recommendation 31
The Committee recommends that should assisted dying be made available, a Joint Protocol be established for inter-agency collaboration between the potential body for assisted dying and the Health Service Executive.
Recommendation 32
The Committee recommends that all assisted dying applications and related processes should be overseen and governed by the independent national body.
The responsibilities of this body will include:
a. Regularly publishing statistics on applications and procedures including statistics on the number of people who initiate the process and the number of people who complete the process and all other relevant data;
b. Ensuring that all applications and procedures are compliant with regulations;
c. Maintaining a list of medical practitioners, nurse practitioners, and psychiatrists who provide assisted dying services;
d. Maintaining a register of medications and return of medication for instances where the person has chosen to cancel their request, was no longer eligible, or has passed away prior to administration;
e. Collecting data pertaining to demographic information;
f. Providing accessible information relating to assisted dying services and supports;
g. The publication of an annual report; and
h. Carrying out preliminary investigation of any complaints or allegations of wrongdoing in relation to the process, and where appropriate make referrals to relevant bodies and to maintain any data for transfer as appropriate.
Recommendation 33
The Committee recommends the doctors have an obligation to acknowledge receipt of the request and should deliver a response within a specified time-frame.
Recommendation 34
The Committee recommends that family members, carers, guardians or holders of an enduring power of attorney cannot request assisted dying in the interest of another person.
Recommendation 35
The Committee recommends that any potential legislation for assisted dying should provide a means of access to treatment for individuals who require assistance during the administration.
Recommendation 36
The Committee recommends that if assisted dying is legislated for, a doctor or nurse practitioner must be present for the duration of the assisted dying process and must remain until after the patient’s death and must account to the responsible authority for any remaining substances.
Recommendation 37
The Committee recommends that any assisted dying legislation include a provision for a formal review after three years of the operation of the legislation.
Recommendation 38
The Committee recommends that any assisted dying legislation must include definitions for terms used, including, but not limited to, medical descriptions of the methods permitted under the Act.
(I hope to provide a commentary on these recommendations in the near future.)
Kevin Hay
You can follow Kevin on 𝕏 @kevinhay77