Oireachtas Joint and Select Committees
Tuesday, 12 December 2023
Joint Oireachtas Committee on Assisted Dying
Examination of Potential Consequences - Protecting and Enhancing the Provision of Palliative Care: Discussion
Rónán Mullen (Independent)
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I welcome our guests again. This has been the best session we have had. It has been very clarifying for anybody who is listening carefully. I am sorry there are not more members of the committee here to hear every moment of these exchanges. It is just the Cathaoirleach and the diehards. Deputy Troy's questions were important as well.
My colleague and friend, Senator Ruane, made me think by her incisive questioning. My mind went to the following place when listening to her, and I want to take our experts into this territory. I refer to the kind of moral pressure that flows if the law changes and if this is available as a choice for some who insist their choice is what must have sway in the final analysis. It is probably not only a question of the moral pressure on medics that they are the experts. We have not had a single palliative care person in the committee advocating for a change in the law. The contrary has been true. It does not appear to be for any particular dogmatic reason but that hey do not believe this is good medicine or that in the end this is not the kind way to treat people. Yet, if they are asked to be involved in it, they might well be made to feel like bad people for not wanting to go along with what they would regard as bad medicine. That illustrates some of the social dynamics at play.
It also worries me that if this moral pressure could be placed on medical healthcare professionals, then what moral pressure comes on those who are in those care settings and who might not otherwise want assisted dying? This was brought out to me in an article by Hugo Rifkind in The Times. He was fair in his assessment of the late Diana Rigg's insistence on euthanasia as a right and a choice. He said that to some degree there is an unanswerable element to it. He also worries about the constant expectation that the patient must be deciding proactively how much they should continue to bear, mentioning the implied morality of being terminally ill, being cared for by others and not wanting to die. Proponents of a change in the law here might be more inclined to consider the problem there is if it could be made clear that there are other victims if you change the law; that it is not just about what the individual wants and that nobody differs with that choice.
Let us say you could have palliative care and assisted dying, and we had an Australian expert last week saying we could do so, and then somebody makes a life or death decision. Is it really like that or does the existence of the life or death decision spoil what palliative care can do? I do not want to put words in the mouths of the witnesses but is that the problem? Does it change palliative care? What has happened internationally in the funding of it? What do the witnesses have to say about all of that once some form of assisted dying is introduced? Does it spoil what can be done for everybody?