Dr. Feargal Twomey:

In essence, if a patient is experiencing a natural death and is coming naturally close to the end of their life, they will often say to me “I do not want to keep going like this”. Some people would say long before their death that the prospect of life ahead is something they do not want. They ask me and I discuss with them whether they could avail of assisted suicide, and I was asked how a person would get to Amsterdam in one more recent case. A lot of that is about the fear of what could come, the fear of what is in the media and the fear of the unknown. For many people who have realistic and honest information given to them, with questions answered honestly and openly and with a realistic expectation of what is likely to happen to them, that distant request for death dissipates.

To focus on the last days of life, there are times when a patient at the very end of their life is distressed, restless, has delirium and is fluctuating in and out of consciousness because they are dying. If they are distressed in that setting, medications that may have a sedating effect can be used for pain, nausea, breathlessness or distress. However, used in moderate and appropriate doses, titrated and monitored closely in keeping with modern specialist palliative care and palliative medicine, these medicines have not been shown to accelerate anyone's death.