A CHARMING elderly English couple chat and laugh over a cup of tea with a German woman, who then asks the man: “Are you sure you are ready to die, Peter?” The old man nods and gives a resolute, “Yes, absolutely.”
This is one of the sobering scenes from Terry Pratchett’s controversial documentary Choosing to Die broadcast recently on BBC. It explored end-of-life options and witnessed millionaire Peter Smedley terminate his own life at the Dignitas apartment in Zurich. He had motor neurone disease.
People who travel from Ireland or the UK to the Dignitas Clinic (a Swiss-based pro-assisted suicide organisation) pass away surrounded by strangers in an apartment in an industrial estate on the outskirts of Zurich.
If accompanied by a loved one the patient has the compounded worry of knowing their travelling companion could face a prison sentence upon their return home. The cost of the service is reportedly between €5,000 and €6,000.
The existing law in Ireland states that it is illegal to assist a suicide in any way. The maximum sentence is 14 years’ imprisonment. Even the act of buying a plane ticket for the person who intends to die in Dignitas could be a crime, says Tom Curran, spokesman for Exit International Ireland, an advocacy group for assisted suicide and full-time carer for his partner, Marie, who has multiple sclerosis.
“The only way that there will be any clarification on the situation is when someone is prosecuted, but I certainly don’t want to be one of those people and neither does anyone else,” he says.
When asked if he is lobbying for a change in the law, Curran’s exhausted expression says it all. “I don’t have the energy,” he replies. His primary role in Exit International is directing people to information on assisted suicide.
In May of this year, gardaí detained two women on the morning they intended to travel to Dignitas. Curran says they were warned of the legal consequences of assisted suicide and consequently did not make the journey. One of the women had MS. Curran says at least six Irish people have travelled to Dignitas to die.
The debate is an emotive one and an easy target for sensationalism in the media, which can skim over the complexities of the issue.
“I think the more we put these matters forward for informed discussion the better,” says Dr Tony O’Brien, consultant physician in palliative medicine in Marymount Hospice and Cork University Hospital.
He feels there is a polarisation in the pro-assisted suicide argument. “There are two options presented: an appalling death with inadequate support and personal care, or assisted suicide. That is not a choice, that is a dilemma,” he says.
O’Brien believes society has a duty to protect its most vulnerable, such as the terminally ill and disabled, and the existing laws provide a safeguard for these people.
“Rather than providing services intended to end life prematurely, we should be providing skilled support across all care domains, that is delivered in a sensitive and compassionate way designed to enhance and enrich an individual’s quality of life to the greatest possible extent.”
Voluntary euthanasia is legal in a small number of countries in Europe, including Belgium and the Netherlands, where the process is physician-assisted. In Switzerland, assisted suicide is permitted and is the only country that will allow non-residents access to these services. This was reinforced last month with a referendum yielding 78 per cent in favour of keeping services such as Dignitas.
In 1995, assisted suicide was legalised in the Northern Territories in Australia, but overturned by the federal government nine months later. It is also legal in the states of Oregon and Washington in the US.
The BBC has been accused of becoming a cheerleader for the pro-assisted suicide campaign by broadcasting Pratchett's film, despite the programme being followed by a Newsnightdebate with both sides of the argument represented on the issue.
In the wake of the Purdy case of 2009, when MS patient Debbie Purdy sought to clarify her partner’s legal status if he assisted her suicide by travelling to Switzerland, the British DPP issued an “offence-specific policy”. This would account for circumstances in deciding whether to prosecute individuals who may have enabled the suicide of their loved one.
The British legal system is still clearly grappling with the issue, but in Ireland the situation remains unchanged, leaving people such as Tom Curran unsure of where they stand.
“She doesn’t want anything to happen to me when she’s gone, but I would not like that to be a factor in her decision,” he says.
So far, nobody has been convicted of assisted suicide in Ireland, although it is clear Irish people have travelled to Dignitas to die and not unaccompanied. A bereaved spouse standing in a courtroom sentenced to 14 years for enabling their partner to end their lives out of compassion for their pain and distress seems unimaginable.
In some ways, the situation is reminiscent of a time when women travelled to England seeking abortions, fearing the social and legal consequences upon their return to Ireland.
In 2011, there is no legal framework or discussion which responds to the sensitivities or contexts related to assisted suicide apart from an outright ban.