Lynn Ruane (Independent)
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I thank the witnesses for their presentations. Last night, I researched this issue and tried to read wider than the submissions that were provided in order to understand or, as a person with zero medical experience, try to understand some of the implications and complications associated with this. I am finding it difficult to come up with questions because I am more in a process of thinking and processing the things I am trying to understand. I will try my best to capture it. My instinct is that conscientious objection should be valued and respected. When I go one step further, however, I wonder about the parameters and limits of conscientious objection. Moral integrity, rather than professional integrity or whatever, is the paramount reason that in some limited areas of medicine or medical care conscientious objection is accepted, valued, protected, given and all those things, but the moral integrity of that individual seems to outweigh the moral integrity of the patient who has a right under law to access this if he or she meets the parameters and criteria. It is about finding the gap between those two. How does one balance the moral integrity of the individual who has a right under law with the moral integrity of another person to have a conscientious objection? That is where compromise comes in with regard to legislatively accounting for steps the individual who is objecting should take in order to ensure the moral integrity of the patient is upheld and not ignored. I read Dr. Neal's submission and hope I have not misunderstood it. She is basically saying that in this space, even engaging in literature or referral should be included in conscientious objection.

That places a massive weight on the hierarchy of a professional's moral integrity and dignity, rather than on vulnerable patients, who may not have the ability to access that information elsewhere or may have no family. The professional in question may be the patient's primary doctor. Do the other witnesses agree that conscientious objection, as I understand it from Dr. Neal's piece, includes the referral process or even bringing a different doctor into the room? How can anyone balance that?

There is also the therapeutic value piece. From some of the pieces I was reading on the issue, one would get the sense that people should not have access to assisted dying because it does not have therapeutic value from the point of view of the medical profession. How do we define what therapeutic value is? It may be that dying well in accordance with one's wishes has a real therapeutic value, even if the result is the end of life. How does the profession define therapeutic value or potential? Continuing to live may have no therapeutic value at a certain stage of a person's life. How do we determine what therapeutic value is?

Does conscientious objection when it comes to upholding the law only exist within the medical profession? This is where I begin to struggle on contentious issues. Doctors, nurses and other health professionals are not the only people with a conscience or moral integrity around upholding laws within society. I will take the area of drug use, for example. Imprisoning an addict who has been caught with heroin does not have any therapeutic value. Some gardaí, judges or whoever may ask why they cannot conscientiously object in those circumstances. Why do other people not get to conscientiously object and say it is against their moral imperative to uphold this law? Why does conscientious objection exist in the medical profession but not elsewhere? Maybe it does exist elsewhere and I am not aware of it.