Mr. Garret Ahern:

I thank members for the opportunity to come here and address them. First, I wish to thank the oncology and palliative care teams in Cork University Hospital who worked heroically and valiantly in the care of my wife, as I am sure they do every day in the care of all their patients. My wife Vicky Janssens died by assisted dying in her home in Belgium in April of this year. I will give members a brief history of the events that led up to this action.

Vicky was a metastatic breast cancer patient for more than ten years. When I met her six years ago, she was about to be discharged from the observation period because the medics believed her cancer had been successfully treated. Within a short few weeks of Vicky and I first meeting, the cancer returned. There were lumps in her neck and it transpired that the cancer had metastasised to her lymph nodes. So we began, as many others do, on a rollercoaster for six years, which, thankfully, prolonged Vicky's life.

Over those years, the cancer became progressively worse, metastasising to her lungs, liver, bones and, ultimately, her stomach, which is when the cancer became too much for her to bear. These symptoms included a loss of appetite and inability to eat without feeling the need to vomit because the normal transit of food could not pass through the tumorous obstructions that were in her digestive system.

The terminal diagnosis was delivered in December 2022 and we began, despite Vicky's reservations, on a programme of chemotherapy, along with support in the form of pain management from the palliative care team. Regrettably, none of these interventions showed any improvement in Vicky's pain levels and there was a marked deterioration in her quality of life. In a terse exchange one day between Vicky and the palliative care team, she had expressed the fact that she did not find the medication efficacious and asked if medical cannabis might be considered for her symptoms. I am not in any way questioning the judgment of the palliative care team on this but it was said that medicinal cannabis was not indicated for Vicky’s condition.

Afterwards, in tears, she told me how extreme her pain was and that she felt she could no longer manage it. She also felt she was not being supported by her medical team in this respect. She asked me what would happen if she consumed all of the morphine we had in the house. I can only say I advised her in the strongest possible way that this would be a bad idea. I had worked in suicide prevention in Limerick for a number of years and I have seen the after-effects of suicide. I told her that this rarely ends well and that the outcome may not be as she intended. At this stage, which was in January 2023, Vicky put in place a chain of events that would lead to her attempted suicide in mid-February 2023. Subsequently, a back-up plan was put in place in our decision to travel to Belgium to avail of medically assisted dying. I believe the thought process and mental state of my wife were sound. I also know she did not want to end her life, rather she only wished to end the agony she was going through on a daily basis. Her life had become one of constant and intolerable pain, which I would like to emphasise. Those might come across as only words but it is the day-to-day living in suffering with that constant and intolerable pain which she had to endure and we, as her loved ones, had to endure watching the woman I loved rapidly deteriorating.

In mid-April I was presented with an ultimatum of sorts, one that I was under no pressure to acquiesce to. Vicky told me she had made the arrangements to travel to Belgium to end her life, and that she merely needed to know whether it would be me or one of her lifelong Belgian friends who would accompany her. I had supported my wife through her entire cancer journey, including the last painful months, and I could not abandon her in this final agony. We travelled to Belgium in mid-April of this year. My wife was in extreme physical pain at this stage. There was also extreme emotional pain. She was leaving behind her daughter, who did not accompany us on this journey. She was also leaving behind the dear friends she had made over the past 20 years in Ireland. Perhaps more importantly, she was leaving behind the country she considered home. We spent four days in Belgium, alone and in isolation for the most part, dealing with what lay ahead. Vicky could not leave the apartment and she could barely get out of bed. The procedure took place in a friend's house on 21 April at 2 p.m. It was the most dignified and peaceful passing I have ever witnessed.

The trauma is not in the administration of assisted dying but rather in the loneliness, isolation and lack of support we both endured during our time in Belgium. Had a procedure such as this been available in Ireland, albeit with the most strict guidelines and safeguards the State could provide, we, her loved ones, would have been saved this emotionally and psychologically harrowing ordeal. I would also like to add that I believe quality of life can be found in the most difficult circumstances and I am by no means suggesting that the vulnerable, elderly or people with disabilities should in any way be coerced into a choice such as this. There should be a rigid examination of the medical facts and there should be a psychological assessment carried out on a patient wishing to avail of assisted dying or expressing their wishes in that regard.

The committee members have an unenviable and momentous task ahead of them in their deliberations. I would only ask that they take into consideration my story, however tragic it might seem.

I also feel that this story is one of many that are unfolding in this country right now, as we speak. I thank the committee for taking the time to listen to me.