Pa Daly (Kerry, Sinn Fein)
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I thank the witnesses for coming in and supplying us with their opening statements in advance.

I was interested in the doctrine of double effect Mr. Keyes described. I have three questions. The first relates to the vulnerability Dr. Campbell outlined and the need for valid medical second opinions, oversight and time limits. She mentioned the knowledge gaps among clinicians and, in the same paragraph, also mentioned emerging research on the significant role played by values and emotions. Is it her view that this is very amorphous and not very fixed? Is it the case that we are developing all the time? I have some concerns about how a person's capacity is affected. What qualifications should people have if they are to assess capacity? Dr. Campbell mentioned mandatory training for health professionals. Can a GP give such an assessment or should it be a psychiatrist who can screen for certain things? I worked as a solicitor for a number of years. I was not trained in screening but sometimes, when someone would come to the office, there would be a family member outside the door. Some members of the family who had rights of entitlement under the Succession Act 1965 were being completely excluded. That set alarm bells ringing straight away. Will Dr. Campbell expand slightly on the actual or perceived pressure she mentioned? Does she have recommendations on how to handle the need for mandatory training and screening in an emerging area in which there are gaps in our knowledge?

My second question is on palliative care. How important does Dr. Campbell think that is? I have no doubt that we will hear from palliative care practitioners in later sessions. Does she think there is enough knowledge of palliative care? I am from County Kerry and there is an excellent palliative care section in University Hospital Kerry. The section has been encroached upon by other sections, including oncology. The palliative care section wants to get these back out so that it can continuing providing that excellent service. However, such services might not be as good in some other areas. Dr. Campbell mentioned existing inequalities and the lack of services. How important does she believe this area is?

If she will bear with me, I will ask my final question so that I will not have to come back in. Dr. Andrea Mulligan appeared before us last week and she spoke about the dangers of a cultural shift that could arise from this. Dr. Campbell touched on this. I am talking about considering death as a treatment option and how that could be embraced by others, as she said using such strong words. Those are my questions. Perhaps she could give me some time on them.