Ms Paula O'Reilly:

I thank Senator Seery Kearney. If one looks at the long submission from the Irish Hospice Foundation and the consultation we have done with the public, one will see that the Senator is correct that the term "dignity" comes up a great deal. It comes down to people's understanding of what end-of-life care looks like. One of the key recommendations for us relates to the fact that Ireland is very good at funerals but not so good at having discussions around dying and death. We very much have an opportunity to ensure end of life, and the choices around it, is done in a compassionate way.

Our recent report, "Dying Well at Home", referred to the small things that families want, such as music playing in the room, as the Senator mentioned. Importance is attached to who is around the dying person, their affairs and their care. That very much requires co-ordination of care in order for us to be compassionate and to deliver what most people want, which is to die at home. Not only must palliative specialists and palliative care be available towards the end of life, but there must also be a broader system that looks at where the home care, the education and the financial impact is. When one is looking at dignity at the end of life, one has to look at it as part of a systems approach and one must consider how all of these parts are integrated to ensure end-of-life care and bereavement support are there.

The Senator mentioned the idea of a good death. In some ways she is right, in that Kathryn Mannix talks about the stages. One must not get carried away with the idea of a good death, however, because even if one has all of these factors, death is still difficult and people will still grieve. It is a question of looking at how compassionate we can be around end-of-life and bereavement care for people.