Catholic Medical Quarterly Volume 74(3) Aug 2024

Correspondence

Letter to the people of Jersey re assisted suicide

The following is an open letter sent to the people of Jersey about Assisted Suicide

As psychiatrists, we have extensive experience of assessing those who express the wish to die and we are writing to express our deep concerns about proposals to introduce assisted suicide in Jersey.

It is misleading to claim that “assisted dying” is not the same as assisted suicide. Suicide is an intentional act undertaken by an individual with the aim of ending their own life, an act that does in fact lead to their death. There is nothing in the legal definition of suicide about severe or life-limiting illness or predicted imminent death being exclu- sion criteria. What is being proposed is a change in the law to allow physician-assisted suicide.

Such legislation severely undermines our efforts at suicide prevention. The argument for physician-assisted suicide is being championed by people who are typically well-connected, self-assured and articulate, in the name of personal choice. The risks affect those least able to speak up for themselves – those with longstanding social and mental health problems and poor social support. To protect these vulnerable and voiceless people, we need to maintain the law as it stands.

Physician-assisted suicide is more unpopular with medical professionals than is usually acknowledged. A survey of members of the Canadian Medical Association in 2022 found two thirds against involvement. In Victoria, Australia it has proved difficult to find doctors willing to be trained for involvement. This year a survey by the BMA of its consultant members found that only a quarter would consider active involvement in assisted suicide. Reassurances about conscientious objection clauses may not cut much ice. How can a psychiatrist stay uninvolved if they are aware of somebody being considered for assisted suicide in a system that does not take full account of that person’s social and psychological vulnerability? So this is another harm likely to be caused by assisted suicide legislation: Jersey will be less attractive as a place to work for doctors with expertise in psychiatry, long-term illness or palliative care.

Support for physician-assisted suicide, in the name of assisted dying, may appeal to legislators because of the attraction of freedom of choice. It has unintended consequences however, for vulnerable people whose personal choices are limited by social and personal circumstances, and for a medical workforce that remains uncomfortable about a practice that does not sit well with their vocation.