On 22 March 2024 the 245 page proposition for Assisted Dying was tabled by the government of Jersey. It states — in bold! — that “This report sets out detailed proposals for establishing an assisted dying service in Jersey, including all processes and safeguards.”
The legislative process in Jersey is quite convoluted. This proposal is obviously the detailed basis of legislation, if approved in May. (Thanks to Rachel Ruddy @Ruddy_Jersey on 𝕏 who notified me of the release.)
TIMEFRAME
The proposal was released on 22 March and the debate in the legislature is scheduled for 21 May. There are only 2 public input sessions — the first on 26 March which is scheduled for LESS THAN 2 hours duration! This means that the public in Jersey have 5 days to assess a 245 page document and provide input during a 105-minute session…just WOW!
(Click image to link to PDF of the Proposal)
As the document is very long and detailed, this is an abbreviated review to provide CA readers with the bare-bones of the proposal and a link to the document.
The document notes that it is following the Citizens Jury, States Assembly debate and Ethical Review. They omit to mention the BIAS in the selection process for the 23 members of the Citizens Jury!
(Click image to follow link to review of Citizen’s Jury.)
BASIC PROVISIONS
The Jersey provisions are very similar to other jurisdictions though they are specified in great detail.
Jersey plans for both Assisted Suicide and Voluntary Euthanasia for adult residents who are competent, non-coerced, etc. There are 2 access streams or “ROUTES.”
The first route is for Terminal Illness which has a 14-day waiting period UNLESS death is expected with 14 days, in which case the waiting period is waived. Also, the second consent can be waived by the applicant under this route. Death must be expected within 6 months or within 12 months for a ‘Neuro-degenerative” condition.
Route II allows for AS for “unbearable suffering” if the person has:
“an incurable physical medical condition that is giving rise to unbearable suffering that cannot be alleviated in a manner the person deems to be tolerable (which may or may not be a terminal physical condition)”
This applies to both physical and mental suffering. The waiting period for Route II after application is 90 days. The significant addition is that Route II applications have to be approved by a Tribunal also.
A “person’s request for an assisted death has been approved, that approval will not expire” …even if they live beyond the 6 to 12 month life-expectancy!
The applicant has “the option to make a written declaration of ‘confirmation of consent to proceed’ allowing a healthcare professional to intervene in order to complete the assisted death in the event of medical complications during the process of administration of the assisted dying substance, or post-administration of the substance;”
The proposal excludes AS/VE for mental illnesses other than dementia (if competent.) There are some additional safety conditions:
“the assisted dying service will not be considered an ‘essential service’, thereby enabling the Jersey Care Commission to cancel its registration in the event of identified failings, even though it is a service that is only provided by the Minister for Health and Social Services, with any cancellation of registration by the Jersey Care Commission effectively shutting the service down;”
Also, there is provision for the exclusion of certain private facilities and staff:
“that, further to the provisions of paragraph (d), the right to refuse to participate will be extended to the managers and providers of residential health and care services, to refuse to allow for an assisted death on their premises;”
That exclusion is for the administration of AS/VE and does not prevent assessments etc. in the facility.
A clause of paramount importance is the Judicial APPEAL PROCESS which can be initiated by the applicant, their agent or: “any other person who the Court is satisfied has a special interest in the care and treatment of the person, such as a family member;”
“…the law will provide for an appeals process to the Royal Court regarding decisions about - i. a decision of the Coordinating Doctor to accept a determination that the person has been, or has not been, ordinarily resident in Jersey for the required time period stated in paragraph (ii); ii. a determination taken by an Assessing Doctor that - a. the person has, or does not, have the decision-making capacity to request an assisted death; and b. the person’s wish is, or is not, voluntary, clear, settled and informed; and c. a failure, or perceived failure, to make determinations or to act in accordance with the process set out in law, including through the failing of the service or through maladministration;”
Likely, this clause will be used mostly to appeal a refusal though it does provide a safety net for family or “significant other” to appeal on the basis of competency, duress, coercion etc. (NB: There are times when family will be unaware of the application and are unable to appeal.)
Conscientious objectors will not be required to actively participate though they “will be required to signpost a patient to the assisted dying service.” That requires the provision of information about access to the service but excludes MANDATED referral. The proposal allows for Self Referral to the service by phone, email or online form, and direct referral if the practitioner agrees.
There are several clauses which could give some staff pause:
“…an ambulance or patient transport driver could not refuse to transport a patient to an assisted dying appointment)…booking appointments for additional assessments, ordering equipment or undertaking residency checks, related management or governance tasks (for example, refusing to act as a Responsible Officer for an assisted dying doctor, or refusing to undertake financial planning tasks associated with the delivery of the service, delivery of equipment or medical supplies that may be used for the purpose of an assisted dying assessment or the delivery of an assisted death.”
As an objector I would NOT wish to deliver equipment which may be used for AS/VE.
CONCLUSION:
Please note this is a brief review and people should read the document for themselves.
The Proposal mouths the common fallacy that “Assisted dying is not suicide.” (Really??)
Considering the bias in the selection of the Citizens Jury, the quiet introduction of this proposal and the rapidly moving agenda (with first public input during Easter week!) it appears that there is a coordinated effort to ensure that Assisted Suicide and Euthanasia will be introduced into Jersey.
Kevin Hay
You can follow Kevin on 𝕏 @ kevinhay77