Rónán Mullen (Independent)
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To some degree, I respectfully disagree with my friend Gino. I have a strong sense over the past couple of weeks from the testimony of some of those who work more carefully and closely with people in the area of mental health in terms of suicide prevention, our expert psychiatrists and our witnesses today as experts in end-of-life love and care, that there is a real sense that what are proposed as safeguards in theory do not, may not and will not work out as safeguards in practice. I still have the memory of the way in which it was described I think by Dr. Eric Kelleher last week. It is impossible to say that people with mental health challenges will not be caught up in all of this, even if it is not on paper. We have heard about the increasing number of people even in Oregon, which has a conservative law, where feeling a burden to your family and loved ones is an issue of concern – more than 53% I think last year. That is helping us realise that this is not just about an individual’s choice rather it is a choice that actually renders other people vulnerable. That is the common good question and that is the challenge we have. How can we respect people’s autonomy as much as is humanly possible while recognising that there are moments where if you do that, you will hurt other innocent people? That is why it is so important and I agree with Gino in that we must do something, to use his words.

I think the witnesses will be glad to hear that when we were agreeing our terms of reference, we discussed carefully the wording “and other relevant recommendations”. I think where this committee will find agreement is around the need to strengthen a provision for high-quality palliative care and high-quality emotional, physical, psychosocial, spiritual support, not just for those who are dying but those who are living with life-limiting situations. The fact that we do not have that optimum situation in Ireland is another reason we cannot say that the autonomy is possible for people even if all other things are equal. How can people be free when they do not have the supports they need?

I wish to ask one thing and I see a couple witnesses are about to say something anyway. I had a personal experience of a loved one who died a few years ago and I was very involved in his end-of-life care although I was abroad at the time. In the end, breathing was a major issue and there was much discomfort and it was known that he was going to have sedation – I think it is called palliative sedation. Because it was known that was going to happen and he might not return to consciousness, decisions were taken. These were important decisions about important conversations he wanted to have. In a way, it is a world different from the decision of “I will have my life ended right now”. Yet, in another way, it seemed to be similar in the sense that I would imagine in the case of assisted suicide and euthanasia, there will also be a loss of consciousness at a certain point. How do the witnesses see both the distinctions and similarities between what I might erroneously be calling “palliative sedation” and what others seek to have enshrined in law, namely, that some people may actually require that their death be brought about?