Professor Eamon O'Shea:

To take up the question of euthanasia, I have no expertise in that area but I do have expertise in the issue of quality of life and communication about death. That is the first step. That needs to be done first. The emphasis on quality of life and what is a good death requires conversation at a societal level as much as at a staffing level within the services. That is the first stage in this discussion, as my colleagues have stated.

With regard to education and training, there is a paradox, as far as I am concerned, in that dying is an inherently private experience but it is also an incredibly social experience. It is a social experience for care staff and communities and we must think about that in terms of education and training. I am not simply talking about education and training for better care but about attitudes to death. It is about cultural appreciation of death and how to locate death within life - within the living - for the living. That to me is as much part of a holistic approach to death as clinical guidelines or a good policy towards death and dying.

One thing a strategy achieves - this goes back to the first question on expenditure - is to bring together a good deal of information and in that way provide a focus. We know from experience that strategies tend to attract money and that they tend to make us make good decisions on the best approach to the spending of that money. That is one of the good aspects of a strategy.

We definitely must figure out how much we are spending because we need to know that to make good decisions about how to allocate resources. However, there are issues with respect to other strategies. For example, the national dementia strategy is about to be finalised over the next three to six months and within that there must be, for example, some appreciation of dying for people with dementia. In other words, we also must integrate within such sectoral areas issues in respect of death and dying. It is as important to bring such issues into these various places. For example, this is also really important in respect of other chronic diseases.