Jersey proposes Canadian style euthanasia law

Jersey proposal will lead to similar horrific euthanasia deaths as has happened in Canada.

Alex Schadenberg
Executive Director

Euthanasia Prevention Coalition

On March 22, 2024 a proposal for legalizing euthanasia and assisted suicide in Jersey was released in preparation for a debate on the issue on May 21, 2024. 

The proposal claims to be limited to people in certain circumstances but upon further examination, the proposal is not limited to terminally ill people. The definitions within the proposal would open the door to a Canadian style euthanasia law.

The Jersey proposal states that the law will set out the eligibility criteria for accessing assisted dying in the following manner:

A person must meet all the eligibility criteria. They must have been diagnosed with either:

• a terminal physical medical condition, known as Route 1 - terminal illness
• an incurable physical condition, causing unbearable suffering, known as Route 2 - unbearable suffering
• have decision-making capacity
• have a voluntary, settled and informed wish to end their own life 
• be at least 18 years of age
• have been ordinarily resident in Jersey for at least 12 months.

Route 1: terminal illness

To be eligible under Route 1, the person must have been diagnosed with a terminal physical medical condition that: 

• is expected to cause death within 6 months, or within 12 months if diagnosed with a neurodegenerative condition such as Parkinson’s disease or Motor Neurone Disease
• is causing, or is expected to cause unbearable suffering that cannot be alleviated in a manner the person deems tolerable

Route 2: unbearable suffering

• To be eligible under Route 2, the person must have been diagnosed with an incurable physical medical condition that is causing unbearable suffering that cannot be alleviated in a manner the person deems tolerable.

Route 1 is not necessarily based on having a terminal illness since, similar to other western jurisdictions, a person is not required to try effective medical treatment. Therefore a person who is an insulin dependent diabetic would qualify to be killed.

Route 2 opens the door to Canadian style euthanasia because the person is not terminally ill be is experiencing unbearable suffering. The Route 2 definition (diagnosed with an incurable physical medical condition) includes nearly everyone with a chronic disability.

When reading the proposal it states:

• (iii) that, further to the provisions of paragraph (b) where a person has a terminal physical medication condition, ‘Route 1 – terminal illness’, the minimum timeframe between a person’s first formal request for an assisted death and the administration of the assisted dying substance will be 14 days, except for when the person’s life expectancy is less than 14 days when there will be no minimum timeframe; 
• (iv) that, further to the provisions of paragraph (c), where assisted dying is permitted for people who have an incurable physical condition but where there is no reasonable expectation of death within the specified timeframe - ‘Route 2 – unbearable suffering’, the minimum timeframe between a person’s first formal request for an assisted death and the administration of the assisted dying substance will be 90 days; 

Canadians with disabilities are being approved for euthanasia based on having an incurable physical condition defined as "having an irremediable medical condition". People with disabilities are being approved for euthanasia based on having an irremediable medical condition, but they are often requesting to be killed based on poverty, homelessness or an inability to receive medical treatment. Similar to Canada, the Jersey proposal would require a 90 day waiting period for killing people who are not terminally ill.

The recent case of the 27-year-old autistic woman who was approved for euthanasia is a good example of what could happen in Jersey, if this proposal is accepted. The 27-year-old autistic woman claims that she is experiencing unbearable suffering even though the source of her suffering is undetermined. 

The Jersey proposal recommends that a Tribunal approve euthanasia for people who are not terminally ill. It is impossible for a Tribunal to determine if a person has suicidal ideation and claim to have unbearable suffering because they want to be  approved for death.

The Jersey proposal advocates for both euthanasia (homicide) and assisted suicide. The proposal states:

(x) the assisted dying substance that ends a person’s life may be – i. self-administered by the person; or 

ii. administered by the Administering Practitioner; 

Administered by the practitioner means the practitioner directly causes the death (homicide). 

The Jersey Assembly needs to understand why the Canadian law has become so extreme. They need to reject the Jersey euthanasia proposal.

Some might say that Jersey should simply amend their proposal. Considering the Canadian experience, once the door opens to killing by euthanasia, based on equality and discrimination, the law will quickly expand to ensure that every Jersey citizen has equal access to being killed.

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.

Jersey assisted suicide debate delayed

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Jersey Evening Post reported on October 5, 2023 the announcement by Jersey Health Minister Karen Wilson last Monday, that the debate on the proposed assisted suicide law will take place during the third quarter of 2024, rather than in February as originally planned.

Jersey is an island country and self governing Crown Dependency and the largest of the Channel Islands, with a population of around 100,000 people.

Duty of Care Jersey and the Jersey Dying Well Group, represented by retired GP Dr. John Stewart-Jones, consultant psychiatrist Dr. Rachel Ruddy, and GP Dr. Andreas Melchior stated in a press release: 

“The decision is an important and welcome development as it allows more time for politicians, especially the 21 newly elected States Members who played no part in the previous discussions, to properly understand the complexities of introducing assisted suicide and euthanasia into healthcare.

“Since the vote in principle in favour of assisted dying in November 2021, there have been significant amounts of new information of the growing harmful effects of introducing this into law, especially in Canada, which legalised medical assistance in dying by euthanasia and assisted suicide in 2016.

“Since then, there has been a continual erosion of the so-called safeguards that were initially set in place – this is especially relevant to Jersey, as the proposals closely mirror the Canadian “twin-track” approach for terminal and non-terminal illnesses.”

We have always maintained our concern and stance on the topic of a change in law, as when taking such decisions the politicians involved must give due consideration to those most vulnerable in society, to the lowest common denominator, and we don’t believe that this was the case when the ‘in principle’ vote was taken by the last government.”

Alex Schadenberg in scheduled to speak in Jersey in early November 2023.

Article: Doctors in Jersey oppose euthanasia and assisted suicide (Link).

Jersey (UK) is debating the legalization of euthanasia

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I reported a few days ago that a group of Jersey physicians told the government that they oppose the legalization of euthanasia and assisted suicide. The physicians were informing a euthanasia debate that was scheduled in the Jersey State Assembly. Jersey is a self-governing Crown Dependency and the largest of the channel islands.

BBC news reported that the Jersey State Assembly voted in favour of debating proposals to legalize euthanasia and assisted suicide. The BBC article stated that this is the first step in a process that would likely be completed in 2023. The BBC news article stated:

But this historic vote represents the beginning, rather than the end, of a process which might - or might not - eventually see assisted dying legalised in the island.

Detailed work will now begin to determine how assisted dying could be permitted while ensuring vulnerable people remain safe.

At least two more separate votes will be required before the law can be changed.

Deputy Richard Renouf, Minister for Health and Social Services, spoke against the proposals, saying:

"Safeguards can be built up and to the best of our ability, but none of them can be truly effective.

"None of them would truly protect patients who are going to become vulnerable if assisted dying were to be introduced."

This is the beginning, not the end of the debate. It is our hope that Jersey State Assembly members will listen to the voice of Dr Carol Davis, consultant in palliative medicine who said:

"Legalising assisted suicide and euthanasia is a seismic legal, ethical and moral change and it carries serious risks to society and particularly its most vulnerable members."

More information on this topic:

• Doctors in Jersey oppose euthanasia and assisted suicide (Link).
  

Doctors in Jersey oppose euthanasia and assisted suicide

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The BBC reported that a group of Jersey health professionals urged Jersey's health minister to not legalize euthanasia and assisted suicide. Jersey is a self-governing Crown Dependency and the largest of the channel islands. Jersey is currently debating legislation to legalize both euthanasia and assisted suicide.

The BBC reported that the health professionals letter stated:

 "We are concerned about the most vulnerable members of our society who may feel coerced into a decision they would not make if the law did not permit it."

"It is very hard for clinicians to diagnose unbearable suffering or to predict time to death accurately for many conditions,"

The letter concludes: "We will not participate should this be passed."

The BBC also reported that:

Dr Carol Davis, consultant in palliative medicine, said: "Legalising assisted suicide and euthanasia is a seismic legal, ethical and moral change and it carries serious risks to society and particularly its most vulnerable members."

Dr Tracy Arun-Castro expressed concern any legalisation of assisted dying could be extended to allow the euthanasia of children.

This is not the first time that Jersey has debated the legalization of euthanasia and assisted suicide.