Professor Ella Arensman:

My colleagues, in particular Dr. Griffin, and others in the NSRF have tried to look into the future. Obviously there would be a requirement for a range of safeguards but, again, as a starting point, I would start with a positive for Ireland. Ireland is now in a position to review and look carefully at other countries where certain developments went very fast, were not always conducted or implemented with the appropriate safeguards or with certain safeguards that may not have provided optimal situations. I will give one example. The college is also aware of some case reports. We are talking about case reports, not hundreds of people, where via what in the Netherlands is referred to as a due diligence procedure, even at a second opinion a person was still assessed as being 100% confirming a wish for assisted dying and then, coincidentally, by a third opinion from a specialised psychiatrist, two of the three psychiatric diagnoses were reversed and suddenly the world looked different for that person. Different treatments were on offer and there was then a drastic shift in moving from assisted dying to living and to at least making the effort of making use of the treatment. We do not want to dwell on it but that is a dramatic case because a person in the Netherlands was apparently very close to assisted dying but with a third opinion the procedure was reversed. Already here, two opinions is not sufficient if we start looking at measuring that, Dr. Griffin and I would very much advocate reviewing those frameworks in the different countries more carefully and then seeing if there is any possibility for a pilot situation in Ireland, certainly in reference to some of the cases that were brought up by Deputy Kenny.

Another important safeguard - Dr. Vanbellingen may be able to come in on this – for many of us working in this area is that15 years ago we would not have been able to predict that following assisted dying or euthanasia for people with physical, chronic terminal illnesses that we would be talking about an 18-year old or a 20-year old girl, boy, or young adult who for non-physical health conditions would be granted assisted dying. We do not have a lot of long-term, follow-up evidence but I am still involved with some steering groups in the Netherlands on suicide prevention efforts whereby now my colleagues in suicide prevention are concerned that there is a fallout from the narratives of these cases in terms of young people who have been granted assisted dying in that it may also accelerate suicide among young people overall.

Dr. Vanbellingen might say more about this. It immediately indicates the boundaries that must be considered.