Dr. Feargal Twomey:

To answer Deputy Lahart's question on chaplaincy in college affairs, some organisations would have had a particular ethos. We are moving from the term chaplaincy to pastoral care and viewing people's spirituality as a whole rather than focusing on any one religion. Clearly our society is moving from one true faith - I usually refer to that being Liverpool Football Club - in Ireland to being separated in two to a more open and understanding situation, accepting of all creeds and, importantly, none, which is increasingly the case.

Burden is a huge issue. Evidence now shows that the burden of being a carer has a great impact on the mental health of carers. The incidence of depression in some patients with cancer is exceeded by the incidence of depression in those caring for them. Regarding the burden of care, by 2042 the Irish population over the age of 65 will have doubled in size. I can happily confirm that I will a part of that population by 2042. There is a burden of care and there is an expense to providing that care. The challenge with burden being cited as a legitimate reason for wishing for medical assistance in dying is what defines a burden and whether other qualifications or criteria need to be met in order for burden to be an issue. Burden crosses into the realm of coercion or unseen pressure from families. While I will not go into detail, unfortunately, I see that frequently in my practice, with sometimes quite malevolent lack of care involving family members and others. It is important for us also to recognise that potential.