Dr. Ciaran Craven:

I thank the committee and the House for inviting me here today. It might be easier if I deal with the questions which have arisen in an omnibus manner. Ms McDonagh has already dealt with the question whether legislation is necessary. The State is allowed a fair margin of appreciation in terms of how it approaches this matter. It ought not to consider that it is wedded to legislation and that this is the only manner in which one may proceed. There are other legitimate options about which we may disagree.

Regarding the question of the X case and whether a conscientious objection might arise in those particular circumstances, even at the time of the X case it struck me that this was bad medicine. If it was not bad medicine then, it is bad medicine now. For one to feel oneself constrained in any sense or be put in a position where one would have to comply with that kind of situation now seems to me to be fundamentally untenable from an ethical perspective.

On the question of flouting of possible safeguards, the members do not need to hear from experts in ethics or law on that. They can engage in their own sociological review on that and that speaks for itself. The question on a licensing board, reviewing whether a certain drug treatment were appropriate in the circumstances, is a point well made and underscores what I have been attempting to say, which is that one should proceed only if one has decent evidence which makes it safe to proceed. That is why I characterise the approach that is being promoted by the Bill as not alone regressive but also potentially dangerous.

Deputy Timmins raised the question on whether there might be any lawful proxy decision makers in respect of issues which might arise. The Bill is silent on it, but that is not a criticism of this particular Bill but a criticism which one might apply across our legal order where there are gross deficiencies regarding the role of proxy decision makers and what one does when one has individuals who are incapacitated.