Humanist Association of Ireland

(HAI)

Submission to the

The Irish Hospice Foundation

in relation to

Forum on End of Life In Ireland

February 2009 

The Humanist Association of Ireland

Submission Forum on End of Life In Ireland

Key points

1 Refusal of treatment to prolong life. ‘Living will’

3 Public concerns and legal issues

1 Refusal of treatment to prolong life

It is, of course, recognised that the palliative care given in good quality hospices would be the first choice of many people with terminal illnesses but there are situations where this is not possible or to a level acceptable to a terminally ill person.

The HAI would like to make the distinction between end of life care and euthanasia/assisted suicide clear; to refuse treatment is legal, on whatever grounds the patient chooses; the autonomy of the individual must be respected. In order to establish what the wishes of an individual are the HAI has been supportive of the creation of an ‘advance healthcare directive’, completed by people while in a sound mind, duly witnessed and ideally with medical advice. The AHD, or living will, has been made available to all via the web site www.livingwillstrust.com. We suggest an advance directive should be reviewed regularly and stored in a national database.

The existence of such a document can be of great help to the medical world and families to clarify the wishes of someone at a stage when they may not be in a position to state their wishes. The absence of such a document has created confusion and anguish in many cases. In the interests of patients, families and medical practitioners we would hope the Hospice Foundation would be supportive in;

1. giving support in principle to this initiative and establishing their status as legal documents

2. publicising the forms and where they may be obtained from, as well as being a provider of such a document once legally recognised.

The Law Reform Commission is also looking positively into the provision of such a document becoming legal in Ireland.

2 Physician-assisted suicide

Suicide in any situation is an emotive word. Terminal illness, suffering, pain, death, complete loss of function and dignity are also emotive words. In a world where medicine can prolong life artificially and machines perform many functions once only open to the human body itself most Humanists would hope that such modern medicine, not able to guarantee pain-free end of life treatment to all could be used where clear, unequivocal wishes have been stated and registered to enable dignified end to suffering. Autonomy of the individual must supersede emotion in regard to end of life issues. The HAI agrees the existence of certain pre-conditions must be met in instances of requests for medically assisted end of life. For example, there is agreement by at least two doctors that there is no hope for remission or cure or the patient regards their own life as unendurable.

3 Public concerns and legal issues

The value of life is of concern for everyone regardless of belief system. Safeguards are necessary in order to ensure the rights of the individual and freedom from prosecution for medical staff; for example, such as having independent medical advice from at least two doctors. We are aware of concerns regarding terminating the lives of ‘unwanted’ family members but legal doctor assisted suicide has been seen to be effective with good safeguards against misuse in many countries and has not ‘opened floodgates’ where in place. We would hope Ireland could move forward to at least open discussion on such issues.

4 Counselling services

The vision of the Irish Hospice Foundation as stated is that “no one should have to face death or bereavement without appropriate care and support”. The HAI shares this vision and has concerns that provision of secular counsellors by the Health Service is an issue which needs to be addressed, especially given the size of the non-religious community*. We would like to ensure hospice staff are aware of patients’ belief systems to avoid distressing them with unwanted visits from chaplains and to be able to provide them with such a service.

*186,318 as persons who ticked No religion, and 70,322 as Not stated in the 2006 Census

 The Humanist Association of Ireland 

The Humanist Association of Ireland (HAI) is a non-profit company, limited by guarantee and not having a share capital, the aim of which is to promote the ideals and values of humanism. Humanism is a positive ethical philosophy of life based on concern for humanity in general and for individuals in particular. It is a view of life which combines reason with compassion. It is for those people who base their understanding of existence on the evidence of the natural world and its evolution, and not on belief in a supernatural power.

Humanists hold limitation of suffering and maintaining human dignity as morally good aspirations; with the right to self-determine as to when good enough quality of life has ended and suffering to be unbearable.

The HAI made a contribution to the Irish Council for Bioethics document, Is It Time for Advance Healthcare Directives? (2007). In this the HAI made clear its unease that the rights of individuals to avail of treatments which could either prolong life or hasten death, thereby ending suffering and loss of dignity, are potentially being prejudiced by the religious ethos of some state hospitals.

The HAI regards the right of religious believers to follow their faith in respect of their own lives; it does not uphold the right of faith of others to determine good quality end of life treatment for others.

Contact Details

Humanist Association of Ireland

Ann James

Secretary:

Rose Cottage,

Coach Road,

Balrothery,

Balbriggan,

Co. Dublin

Tel: (01) 841 3116 or

Mobile: 087 981 7861

Web site: www.humanism.ie

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