Billy Kelleher (Cork North Central, Fianna Fail)
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To ask the Minister for Health if he will provide the Health Service Executive policy document regarding the withdrawal of solids from an ill or disabled person when they are no longer able to swallow; and if he will make a statement on the matter. [5622/13]

James Reilly (Dublin North, Fine Gael)
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Decisions about the appropriate management of patients with swallowing difficulties are the clinical responsibility of the attending medical practitioner based on the clinical circumstances of an individual case. The Medical Council 'Guide to Professional Conduct and Ethics for Registered Medical Practitioners' provides guidance in relation to end of life care. The Guide states that the doctor shares with others the responsibility to take care that the patient dies with dignity, in comfort and with as little suffering as possible. There is no obligation to start or continue a treatment, or artificial nutrition or hydration that is futile or disproportionately burdensome, even if such treatment may prolong life. Doctors should respect the right of patients to refuse medical treatment or to request the withdrawal of medical treatment. The Guide states that doctors should take care to communicate with patients and their families so that they have a clear understanding of what can and cannot be achieved and offer advice on other treatment or palliative care options that might be available to them and ensure that support is provided to patients and their families, particularly when the outcome is likely to be distressing. Doctors must not participate in the deliberate killing of a patient by active means.