Tuesday, November 7, 2023

Government of Jersey Assisted Dying report calls for a law with tight restrictions

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I am currently in the UK on a speaking tour and will be speaking in Jersey on Thursday November 9. Today the government of Jersey released its assisted dying ethical review, a report from the Minister for Health and Social Services.

The research for the report is based on three "specialist witnesses" - Professor Richard Huxtable, Professor Trudo Lemmens, and Dr. Alex Mullock.

The Government of Jersey has indicated that they will likely begin the debate on euthanasia and assisted suicide by the end of summer 2024.

The Euthanasia Prevention Coalition opposes euthanasia and assisted suicide because these acts require one group of people (usually physicians) to be involved with killing people.

BBC news reported:
Adults in Jersey seeking AD eligibility fell into one of two categories; those who are "terminally ill", and those with "unbearable suffering".

The experts, after taking many reasons into account, concluded that proposals for AD for those with a terminal illness were "ethically appropriate".

However, they had "serious reservations" about allowing AD for those with "unbearable suffering", deeming the term too vague.

They concluded AD proposals in such circumstances, "are not ethically appropriate."
The experts are correct that the term "unbearable suffering" cannot be defined and approving killing based on "unbearable suffering" will inevitably lead to expansions of the law, the same problem also exists with the term "terminal illness." Some jurisdictions have defined terminal illness as having a six month prognosis, but that is difficult to define.

For instance, an insulin dependent diabetic who decides to stop using insulin will be defined as terminally ill even though that person has a medical condition that is effectively treatable.

The BBC reported that the experts rejected the option of suicide tourism by finding that euthanasia and assisted suicide should only be available to Jersey residents. The experts supported the right for medical professionals to conscientiously object to participating in euthanasia and assisted suicide.

ITV news provided a little more information on the recommendations. ITV news reported:
It says the term "unbearable suffering" is too vague and too open to interpretation - since physical conditions and tolerance of pain can fluctuate over time and can improve with the right treatment.

“Incurability may be hard to define, and ‘intolerability’ will rest on subjective judgements", Professor Huxtable wrote.

The ethical review also suggested that this "route" to assisted dying may undermine the value of disabled people’s lives - and would risk expanding the scope of the law beyond what was intended.

The review panel states: "Incurability may be hard to define, and ‘intolerability’ will rest on subjective judgements, which may mean the patients seek and receive assisted dying without having tried viable options, which doctors may find difficult and which may mean it becomes more difficult to restrict the practice."

Professor Huxtable cites Canada as an example of a "slippery slope" where more and more people may be eligible for assisted dying when there are other treatment options available to them.

The review only supports allowing Jersey residents to end their own lives, to avoid the island becoming a "death tourism" destination.

It asks politicians to consider a minimum term of residency before someone becomes eligible.

It also states more robust testing is needed to determine whether or not someone is cognitively able to make the decision on whether to end their own life.

The review recommends that patients be required to self-administer the drugs to end their lives to protect them and put them in control by confirming it is genuinely their wish.

An appeals process was also suggested, allowing those with a legitimate interest to raise a legal challenge.

Professor Huxtable said this would increase public confidence and address concerns about "medicalising" the issue.
This report is flawed because it examines how to kill rather than if it is ethical to kill people at all. All the ethical reports based on legalizing the killing only debate the question of who we can kill and who should do the killing. Once legalized the question will change to whether it is discriminatory to continue to restrict the killing to certain groups or conditions.

The killing inevitably opens to more conditions for killing and more people who can kill.

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