What’s being proposed for Jersey seems unbelievably liberal.
Published in the JEP on Saturday 7th January 2023.
Tom Innes reports in the Saturday Interview. (Photo by Jon Guegan).
A LANDMARK vote supporting the legalisation of assisted dying in Jersey in November 2021 might have been seen as the end of the line for those opposed to the idea.
The ‘in principle’ support from States Members has moved the issue on to the next stage – consultation on the specifics of the new law is currently taking place before it is brought back in detailed form to the Assembly this spring.
Conceding privately that they were ‘out-campaigned’ by the opposing lobby in the build-up to the 2021 debate, those who are against assisted dying have redoubled their efforts to highlight their continued reservations.
Earlier this week two organisations – Our Duty of Care Jersey and the Jersey Dying Well Group – held a public meeting in St Helier. Crossbench peer and professor of palliative medicine Baroness Ilora Finlay of Llandaff was the main speaker, and the JEP accepted an invitation to meet her during the visit.
While some of those in favour of assisted dying have pointed out that it has been adopted in several jurisdictions globally, Baroness Finlay said the experience had amplified her concerns.
‘When you look at the population figures, there are only about 6% of people globally who have access to assisted suicide,’ she said. ‘What’s being proposed in Jersey seems to be unbelievably liberal, and more akin to Canada – which is the euthanasia capital of the world.’ Canada, where physician-assisted suicide became legal in 2016, features several times during the interview.
‘We’ve been seeing more evidence of what’s happened in jurisdictions where this has been implemented, and this evidence is increasingly worrying,’ Baroness Finlay said.
‘There have been rapidly escalating numbers, and Canada is the fastest-growing area.’ Vancouver Island, on Canada’s Pacific coast, is highlighted as a close-knit island community with some similarities to Jersey, albeit the population is around eight times larger.
Baroness Finlay cited data showing that 325 people were assisted to die in Vancouver Island from January to July 2021, with this working out at 7.5% of all deaths, almost twice the Canadian average of 4%.
‘One in 13 deaths is very high, and if you translated that proportionately to Jersey there could be as many as 60 deaths [via assisted dying] annually,’ she said.
Palliative care consultant Dr Carol Davis, who also took part in this week’s meeting, said that she was alarmed that financial considerations might become a factor.
The calculation was that the 10,000 deaths in Canada in 2021 represented a cost-saving to the national health and social care budget of CAN$147 million, she added.
Baroness Finlay said she was concerned about abuse, saying there was evidence that one-in-five people aged 65 and above had been affected.
‘A lot of this – 37% – is financial, and most of it takes place behind closed doors and won’t come out into the open – if you are dependent on your son or daughter for your care, you aren’t likely to feel you can complain about them.
‘I’ve also spoken to staff in care homes, who witness what I would describe as subtle coercion from family members who become fed up paying the fees for parents or grandparents because of the effect it will have on their inheritance.’ As part of the UK-based think-tank Living and Dying Well, Baroness Finlay has played a leading role in an official response to the Jersey consultation process, which will close on 14 January.
Among the worries she quoted were that issues such as loneliness and poverty would become reasons that would contribute to someone deciding they wanted help in ending their lives, rather than factors originally cited by those in favour such as pain and other physical symptoms.
‘The thing about symptoms is that you can manage them now,’ she added, describing assisted dying as a ‘20th century solution’ that failed to reflect the advances in palliative care and medicine generally over the past two decades.
‘You have an excellent Hospice [in Jersey], it is much-loved although it isn’t fully state-funded and there isn’t enough daytime respite to meet the need, and nor a full team that can go in and work with specialist services.’ Safeguarding measures form a significant part of the current consultation, and this topic brings a further expression of concern from the Welsh peer.
She said: ‘It’s really evident that the assessment regarding eligibility criteria isn’t about safeguards – should the state be funding a service to end the lives of citizens via a tick-box form filled out when there’s no way of knowing the quality of communication within that assessment?’ Baroness Finlay said she believed many prognoses about patients having a certain number of weeks or months ended up being inaccurate.
‘The worry is that once people have been given a prognosis like this, they are on a ‘death pathway’ and may be denied normal services, when what should happen is that they live as well as they can.
‘If you pour resources into how to end lives, you’re not creating an environment which enables people to live well.’ Other concerns expressed by Baroness Finlay include the impact on the mental health of medical practitioners, and the perception that once a decision is taken, the process of ending a life is a straightforward one.
‘Supporters will claim that it’s a triedand-tested medical intervention, where a person is given one tablet and it’s like turning off a switch, but it’s none of those things,’ she said.
As things stand, Jersey remains on course to become the first place in the British Isles to legalise assisted dying. Detailed proposals will be brought back to the States Assembly this spring, and the law could come into force within three years.
The support came via a clear mandate from States Members, however opponents argue that the ‘in principle’ notion of assisted dying cannot progress without workable safeguards and a detailed process to ensure the practicability of legislation.
Summing up her thoughts, Baroness Finlay said: ‘It is our concern that no sufficient level of safeguarding can be achieved to make an assisted dying law workable and safe, and that the “in principle” assisted dying proposition has been based on inadequate consideration of the factual evidence that points to the inherent dangers of the proposal, which will put more people at risk than it will benefit.’
‘ I’ve also spoken to staff in care homes, who witness what I would describe as subtle coercion from family members who become fed up paying the fees for parents or grandparents because of the effect it will have on their inheritance.
Assisted dying timeline
•2018 – the legalisation campaign in Jersey gathered pace in 2018 when 1,861 signed a petition supporting the concept on the States Assembly website.
•2019 – further evidence of public support via an online survey and a public meeting.
•February 2020 – Health Minister Richard Renouf announced that a citizens’ jury would be convened to examine the issue.
•Summer 2021 – having been delayed as a result of the pandemic, the jury’s report was published.
•November 2021 – States Members voted by 36-10 in favour of the principle.
•14 January 2023 – the consultation process on the detailed proposals is due to close at gov.je/caring/assisteddying.
•March 2023 – proposition for detailed proposals due to be lodged for debate.
•March 2024 – preparation of draft law due to take place.
•Late spring to summer 2024 – States Assembly debate on draft law.
•End of 2025 – implementation period concludes, law comes into effect.
Baroness Finlay of Llandaff bio:
•Consultant physician in palliative care, Velindre NHS Trust, Cardiff.
•Past president of the Royal Society of Medicine.
•Made a peer in 2001, sitting as a ‘crossbencher’ (not affiliated to a political party).
•Proposed a bill to ban smoking in public buildings in Wales, three years before it was eventually implemented.
•President of the Chartered Society of Physiotherapy.
•Director of thinktank Living and Dying Well.