Dr. Feargal Twomey:

I think this is less about the doctors and how doctors feel in the doctor-patient relationship. I think it is fundamentally about individuals and society, of which doctors form a small part, because we live in this country, and those who have needs. In healthcare it is most important that the voice of the patient is heard and that the patient has a say in making a contribution to the joint and shared decision-making about what care is. I think choice is a very strong word. If the Deputy were to ask most young, fit, well people under the age of 30 a question about this topic, it would depend on the question he asked them and how informed they were about the risks and benefits to themselves and others. Increasingly in Ireland, as we move away from the family circle and family caring approach to looking after our elders, respecting our elders and so on, and as we get more modern, life to some people can be seen as a commodity. One of the appalling vistas being considered recently in Holland was that when someone reaches the age of 75, they can decide that have had their life, their life is completed now, and they can apply to have a medication that will allow them to take their own life. That is an extreme of society that I do not think this country would ever wish to get to.

If the Deputy were to ask somebody who is young and well if, at the end of life, if they were suffering and had terrible pain, they would like an option to relieve themselves of that pain, the answer would absolutely be "Yes". The task of this committee under its Cathaoirleach is, on behalf of the State, to get a wide and informed view of what is available, what should be available, and what is safe to provide for us. One of the most important voices I have heard in terms of concerns about audit, scrutiny and regulation is Professor Theo Boer, who I believe has spoken to the committee already. He is not opposed to assisted dying or euthanasia but he was not able to sustain his involvement in the oversight of practice in Holland because it had got so far outside of the regulations and guidelines that had been set.

We need to recognise that we should be very proud of the delivery of care for people with advanced disease and who are dying in this country. We clearly have enormous improvements to make and we need to continue to make those. In my personal view, the addition of the ability to aid someone in directly ending their lives, or the ability of a healthcare professional of any kind to directly end someone's life, does nothing to add to this type of care.