Rónán Mullen (Independent) | Oireachtas source

I am very taken with our journey into a discussion of dementia which, as my friend and colleague, Deputy Higgins, said, we have not veered into that much in these weeks. Perhaps I am not fully ready to speak about it myself, but I would offer this much with certainty. I lived with and helped to care for my own father at home for approximately ten years during the time in which he suffered from Alzheimer's. I can say that we did not let him miss out on anything he needed in order to deal with any pain, including sedation. I can also say that while he would have hated the way in which he became extremely dependent on us for the most basic necessities of life - you know what I am talking about - that enabled a climate of love and care in our family that I never could have imagined being possible. Regardless of what letter anybody might have written in the past about how they would like to be dealt with in the future if they should lose capacity, there is more to the story. There is the story of how the relationship with that person can continue. We need to talk a great deal about dementia before we introduce it as just a matter of an extension of autonomy. Into the future, when one cannot themselves declare their wishes, there is an awful lot more at stake.

I will address a question to Ms Lazar on that point. What I hear very often - and I know Ms Lazar is very sincere about her views - is an emphasis on autonomy and choice. From Dr. Duckworth as well, it is fair to say, this arises more than the question of pain and suffering itself. We have heard and will hear a lot about how, particularly in the context of excellent as opposed to passable palliative care, so much can be done to address the kind of depression and fear of which Dr. Doherty has spoken.

Would Ms Lazar consider that there is also a social dimension to autonomy? If we legislate purely to vindicate people's autonomy, is there not a risk that other people's autonomy might be affected down the line? I refer to the people for whom it may be difficult to assess whether they truly have capacity and who may feel a burden. It is the type of social change in attitude that people like Professor Theo Boer have talked about; the idea and the fear that an ableist society ends up getting its most vulnerable people to move on and, indeed, to want to move on. Is there not that risk when we talk about autonomy?