'Unbearable suffering' should not be a factor in Jersey's assisted dying law, review states

An ethical review of Jersey's plans to allow assisted dying has said "unbearable suffering" should not be an acceptable reason to allow a person to die.

In 2021, politicians in the island agreed in principle to legalise euthanasia in certain cases, including when someone has less than six months left to live because of a terminal illness or is living in "unbearable suffering" because of an incurable physical condition.

Following that decision, an ethical review was ordered to help inform the law drafting process, led by Professor Richard Huxtable, a professor of Medical Ethics and Law from the University of Bristol.

What are the current proposed criteria to allow assisted dying in Jersey?

  • where someone is over the age of 18; and

  • has been diagnosed with a terminal illness, and has around six months left to live; or

  • have an incurable physical condition, resulting in unbearable suffering that cannot be relieved; and

  • have a voluntary, clear, settled, and informed wish to end their own life; and the capacity to make that decision.

Under Jersey's current proposals, there would be "two routes" if a person wanted to end their own life - provided they were over 18 and were deemed to be capable of making the decision.

In other words, as used in the report, the justification for a person to carry out assisted dying would be "to prevent a terrible death" or "to prevent a terrible life".

While the review agreed with the first route - where someone has a terminal prognosis - it argued the second - where someone is living in "unbearable suffering" - was not "ethical".

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.

Professor Richard Huxtable, a professor of Medical Ethics and Law, led the ethical review into Jersey's plans. Credit: General Medical Council

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.

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