Mary Seery Kearney (Fine Gael)
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I thank our guests for their opening statements and the supporting document. I find myself remarkably sympathetic to Professor Jones's argument in his supporting document and his recommendations. They made me think. I am mindful of the third Canadian report that sets out that in 2016, there were slightly north of 1,000 cases of assisted dying and by 2021, that was up to 10,000. I agree with the figures the professor shared earlier.

Building on what Professor Madden has just said, perhaps it is not so much that assisted dying has brought about the environment whereby there are increasing numbers availing of it. Perhaps the requirements and mores of society were moving towards bodily autonomy, and the respect and beneficence that is within medical circles and societies with human rights anyway, such that it was natural that once there was permission, people would exercise that right. I am in difficulty. I swing in and out of where that might be. There has been a widening of the framework when we look at the Canadian model, its legislation, the constitutional case and the challenges whereby there was a widening of eligibility and lessening of the safeguards, looking at it objectively. However, the question has not yet been put to the Irish Supreme Court in a very direct way. It may be that it is only a matter of time before there is a constitutional case if we do not put in a framework.

That brings me to the understanding of medical ethics and where they fit in. A legal framework would put in a context rather than allowing a permissive context. I tried to put an image on that in my head. Let us consider a situation whereby someone with a knife is going to cut into another person. If such a thing were to take place on a street corner or in a domestic violence situation, that is obviously a criminal offence. If it happens in a theatre in a hospital, it is a life-saving intervention. We would then consider the rightness or wrongness of that medical intervention, whether the relevant person has six or nine months to live, how that decision is arrived at and the ethics involved. I am not sure we can get into that space but we can put in frameworks. I tired to figure that through. I thought about the temporal matter, that is, how long we decide. How long should that period of time be? How do we support medical people who will be obliged to make those decisions?

Points were made about decision-makers, assisted decision supports and co-decision-makers. What happens if one of them is a conscientious objector? How do we legislate for all of that?

I think the horse has bolted. We are already in a place where society recognises that suffering should give rise to a choice as to how an individual is obliged to either stay in a place of suffering or not. I completely accept that palliative care and everything like that needs to be increased. However, we are already there. It is now about how we make it as safe as possible. We have a framework. At the moment, we do not allow assisted dying but we allow a refusal of nutrition and medical intervention. We allow all of that. I accept the passive aspect to that and questions about whether we do that or not. However, we are already in that place. What advice would the witnesses give the committee about how we find those threshold points? How are we challenged in that regard?

There is much more to be said. I need to have big conversations. I would value a reply on those points and the nuances involved.