Robert Troy (Longford-Westmeath, Fianna Fail) | Oireachtas source

I thank our witnesses today. I had some thoughts when listening to the responses and the contributions earlier, which I will give in no particular order. In terms of the low number of responses vis-à-visthe size of the ICGP's membership, do you put that down to time pressure on your members, who are extremely busy professionals, or is it down to apathy towards this issue in itself? Following on what my colleague, Deputy Lahart, has said about some of your research, the primary reason for someone considering ending their life through assisted dying would be that they become burdensome in their old age. When we look at the level of palliative care that is available through the CHO regions, it varies quite significantly between regions.

To support what Deputy Lahart said, any report would have to underpin at least a consistency in the level of support available to patients.

On patient wishes versus family wishes, I have always been struck when going to visit someone in a nursing home that, not to generalise given that not everybody who is in a nursing home does not want to be there, the vast majority would prefer to be at home. Unfortunately, in the case of many people who are there, the family has come to the decision that the person is no longer fit or able to be in their home and needs 24-7 care. That is the family's wishes trumping the patient's wishes. Do the witnesses see a scenario where the family's wishes may trump a patient's wishes when it comes to end-of-life care? Going back to what people spoke about earlier, if this were to be introduced, it could be introduced in only a limited set of circumstances and, as everyone has said, with very strong parameters. Where do those parameters stop and how would we ensure, if it were introduced, that that those parameters would remain static? In other jurisdictions, it has been shown that once it is introduced, it will later be expanded and broadened.

To follow on from what Senator Ruane said about conscientious objection, it is paramount that if something is to be introduced, medical professionals must be able to stand back and away from this. Nevertheless, that gives rise at a later stage to that perhaps impacting on people for geographical reasons. I think of the introduction of the termination of pregnancy Act. There was a big report in a national newspaper showing Longford had the lowest number of GPs participating in and offering terminations of pregnancy, and it showed that was unfair to the people of Longford in comparison with, say, the people of Dublin. How do we ensure that if something is introduced, it will be broadly introduced throughout the country without compromising people's clear right to conscientious objection?