John Lahart (Dublin South West, Fianna Fail)
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We could have a very long conversation just about that piece, about a patient's wishes and a family overruling it, possibly, and a GP going with a course of action based on what, I wonder. I do really wonder about the knowledge of the wider family, given the interaction time GPs have with people. It is not particularly long. I have also experienced GP interaction in my own family in those circumstances, where people were coming close to end of life. There is a rich vein there that we do not have time to tap into. I am not querying the ICGP or questioning the integrity of anything our guests have said.

Some of the findings have been very provocative. In respect of the other witnesses as well, these last few sessions have been where the substance of this issue is beginning to gain real traction for me as a member grappling with the issue. There are issues that were raised today regarding the burdensome piece, the dignity piece. I am really interested to see that there is a lot of research going on in this regard, so we have a lot of information available to us.

As a legislator, for me a big part of any report would be to emphasise that the State needs to bend over backwards and redouble and treble its efforts in relieving people. If the feeling of being burdensome is one of the reasons people want to end their life, the State has an obligation to reinforce its efforts and do whatever it can to ensure people do not fall into that position. As a legislator, however, I am also aware that the State has limited resources. We see it right across the medical system. If we could wave a magic wand, no one would feel loss of dignity because they would have all the supports, interventions, back-ups and love and care. Nor would they feel a burden if we had all the psychological and therapeutic supports in place that we could give them. I am just stating the facts as I see them and I wonder whether it is beyond the State to do all that. A big part of our report should be that the State needs to look at this. We are not doing enough in terms of people feeling a burden.

I am very taken with the conscientious objection piece. This is where the rubber hits the road when we make a law. Who is going to implement it and how do we protect them? We see how tricky that is. On the Canadian evidence, I am not saying it is progressive or regressive, it is what it is. I suspect that culturally and societally, they are in a different space from where we are. I am not commenting as to whether it is a better or a worse space. The evidence was that they are much more comfortable with clinical conversations about this among professionals. We need to look at that as well. I am very taken with the dignity piece and the fact there is more and more research going on, in parallel with a demand for end of life and assisted dying interventions. I am glad there is lots of work being done around the burden piece and the dignity piece. For me, that would be a big part of what we report on at the end of this.