Mary Henry (Independent)

I welcome the Minister of State to the House. I also welcome his speech, which really addresses the issue of suicide. We are fortunate to have here people like Senator Glynn who have experience of working in the psychiatric services. I have little to add to what the Minister of State, Senator Browne and Senator Glynn have said. While doctors and nurses in the psychiatric service get considerable training to become aware of people who may attempt suicide and in how to deal with those who are suicidal, we should place greater emphasis on the possibility of suicide in the general training of medical students, particularly those who become general practitioners.

Senator Glynn is right to highlight accident and emergency departments. I have seen people who had taken overdoses treated on a much too casual basis owing to not having people with an expertise in psychiatry to whom they could be referred. All accident and emergency departments should have a psychiatric nurse available at all times to whom a patient who arrives after making a suicide attempt can be referred and a proper follow-up can be instituted.

I have frequently raised the issue of bullying and I was glad to hear Senator Glynn raise it again. As well as having problems with alcohol and depressive illness, we find that a considerable number of those who commit suicide may have been subjected to bullying. We should tell people that bullying is not only bad for the individual but for the organisation in which he or she is involved. The issue of support for the bereaved has been raised, something extremely important. However, it is also very important to remember the professionals who may be dealing with such people. They have a great sense of failure if a person commits suicide. Support for nursing and medical staff and for prison officers is essential.

The last issue I would like to mention is the problem of the very difficult ethical struggle regarding assisted suicide. It was great that Pope John Paul II made his illness so public and that his wishes were acceded to when he said that he did not wish to return to hospital. Perhaps we need far more discussion regarding those with terminal and chronic illnesses. Nothing appears to happen except when a case hits the headlines. Should a percutaneous endoscopy or gastrostomy tube be replaced? It is terribly hard for those who are dealing with such cases to be involved in the decisions regarding what should happen to the patient. There should be far more support from clinical ethicists for those of us in medical or nursing practice dealing with the terminally and chronically ill. Situations may seem very simple from a distance, but they are sometimes extremely complex. The stress on the family is always looked at very carefully, but the stress on staff is extraordinarily difficult too, and I would like us to make more of an effort to get the advice of clinical ethicists into those hospitals where such help may be needed. The issue will arise more and more. People have left Ireland for assisted suicide in other countries. I would like to think that those people who decided to go had also had the benefit of advice from such people as clinical ethicists.

I greatly applaud the work of the hospice movement, which should be mentioned in this context. Hospices have made life totally different for those who are dying, particularly that majority of us who would wish to die at home. We must recognise there is a group of chronically or terminally ill people, sometimes with conditions which cause absolutely dreadful deaths, such as motor neurone disease. We must address that. We managed to address suicide, which for years had such a stigma, and now we are seeing in what practical ways we might deal with this. We can also deal with the situation regarding the terminally and chronically ill.