Lynn Ruane (Independent)
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I have two questions. Much of the debate on capacity has mostly considered mental capacity and how that can change. However, there is also physical capacity in terms of something progressing that affects someone's physical capacity to be able to see through their decision, say, a person who regularly insisted on assisted dying having the lack of physical capacity to see through the decision he or she made with full mental capacity. That full mental capacity may be still there but not necessarily the physical capacity.

Obviously, that comes into the conversation around the difference between assisted dying and euthanasia. When we talk about safeguards, we are mostly talking about safeguards for the most vulnerable and making sure that they meet the criteria to be engaged. However, there are also the vulnerable patients in terms of what safeguards are in place for vulnerable patients who have lost the physical capacity to be able to see through a decision they made on their end of life.

Is there a framework within assisted dying, without moving the conversation to euthanasia, where somebody within a family or an advocate, can be appointed by an individual to assist? I refer, for example, to help picking up a cup to drink a liquid. Can a family member help? My father is the first person who got me thinking about assisted dying when he expressed the wish that once he lost his mind, he did not want to live. That sparked big conversations in our house and between me and him as he lost more and more capacity. It was not a regulated system anyway, but he definitely would have needed help. How do we account for that, so that we do not let down people who lose the physical capacity to be able to see it through? How do we make sure that it can be exercised?

The second question I have is probably a bit of a reach. I am not sure I fully support the idea of assisted dying being limited only to terminal illness and time limited in the sense of it only being in proximity to death. I also have lots of question around mental illness. The idea is that we need lots of safeguards in that regard. I feel we also need to weight mental suffering in the same way as we weight physical suffering. The thinking is based on terminal rights. "Terminal" means that a person is likely to die or that is the trajectory of the illness over whatever period of time, or that the illness is likely to cause death. The argument could potentially be made that when it comes to decades of suffering with a chronic mental health illness that has not responded to treatment, and in spite of various types of treatment interventions, life has not improved. A person could say that he or she intends to end his or her life in the next six months. When do we say that terminal illness is only related to physical illness? Can the idea of a terminal illness also be associated with a mental illness on the basis that it is going to lead to death, but it might be by one's own actions rather than the disease? I know I am reaching there in terms of what is causing what, but I feel there should be a space where, after treatment, a person with mental illness should not be excluded from the conversation around assisted dying if he or she so wishes.

When we spoke about disabilities, Dr. Campbell stated that it goes without saying that people with disabilities will also want to engage in this conversation and others will not because they feel they are being pushed in that direction as a result of the lack of services. Would some mental illnesses also fall under the term "disability"? I wonder how much we are separating mental illness out from all other illnesses in regard to this decision.