Dr. Una Molloy:

The Irish Association for Palliative Care is a non-government organisation initially formed in 1993 with the purpose of promoting palliative care nationally and internationally. We use our collective expert voice to advance palliative care in Ireland. The membership, which comprises various health professionals, reflects the entire spectrum of those who work in or have professional interest in the provision of palliative care in Ireland. Palliative care is a philosophy of care that improves the quality of life of patients and their families, who are facing challenges associated with life-threatening illness, by preventing and relieving suffering. This is done by means of early identification, assessment and treatment of pain, and other physical, psychosocial, and spiritual problems. We acknowledge the suffering of those with serious medical illnesses. Our focus is to help people experiencing distress by alleviating their suffering and this does not include ending their lives.

Palliative care may be provided at any stage of a life-limiting illness, not just at the end of somebody's life. Some people fear being subjected to treatments that are inappropriate, burdensome and ultimately not beneficial. We endorse and support the right of competent informed patients to decline medical treatment even if this leads to their deaths. Palliative care cares for people both on life-prolonging treatment, and when there is a redirection of care, to focus on treatments that provide comfort and symptom control. Some requests for euthanasia or assisted suicide result from worries of uncontrolled physical or psychological suffering and there is a misconception that dying is inherently painful, traumatic and undignified. Basic principles of palliative care require that doctors and other healthcare professionals support patients to be comfortable and pain free. Palliative care focuses on the delivery of care in a person-centred compassionate way. In practice, there can be a misconception that medications, particularly opiates, are used for hastening death rather than for symptom control. This misplaced belief and fear can form a barrier to patients achieving good symptom control.

As a society, there needs to be more discussion about death and dying to dispel myths and fears and to be informed about end-of-life care options. There also needs to be education and support of healthcare professionals having these discussions, which can be challenging and emotive.