Sir, – Responding to letters from the Irish Hospice Foundation (June 4th), and the chairman of the Human Rights and Ethics Committee at the College of Psychiatrists of Ireland (June 5th), regarding the Dying with Dignity Bill, now passing through the Oireachtas, we observe the following.
As an affluent society with an aging population of medically complex people, the Irish health system is increasingly anomalous in that it does not yet provide its citizens with the choice of medical assistance in dying. Our view is that introducing this is complex, important and overdue. We have confidence in the process of the Oireachtas, and expect that in the scrutiny and amendments, the present version of the Bill will benefit from relevant expertise through the committee process.
For an increasing number of people, the choice to avail of a well-considered, timely and available clinical service is of paramount importance, should they find and see themselves in the position of having a pre-terminal medical condition, characterised by unrelievable suffering.
The current Bill, as presently proposed, is conservative, relative to systems of care in other societies. Certainly, consider a citizens’ assembly. By all means tweak the title of the Bill. Please do not conflate the issue of adequacy of palliative care services nationally with the issue of medical assistance in dying – they are both important but separate issues. And please avoid any reference to slopes, slippery or otherwise, as unscientific, declamatory, emotive and unhelpful. In none of the growing number of jurisdictions where medical assistance in dying has been introduced in the last 20 years has the service been withdrawn or limited as a result of data or feedback or experience relating to growing numbers of people who have chosen to avail of it. – Yours, etc,
Dr ANDREW LYNE,
Dr BRENDAN O’ SHEA,
Dr SINEAD COTTER,
Irish Doctors
for Medical Assistance
in Dying,
Dublin 2.
Sir, – Dr Ciaran Clarke (Letters, June 5th) states that the College of Psychiatrists questions the need for the option in the Dying With Dignity Bill for terminally ill persons to end their suffering with the help of a doctor.
Many people have a “bad death”, in pain and with great loss of humanity. To me it seems compassionate to allow such people the chance to end their suffering and to die at the time and place of their choosing. Such legislation has been in place for decades in some places, and I dispute Dr Clarke’s unsupported assertion that there is a slippery slope.
No-one denies that palliative care is a good thing and must be supported. However, it is not always successful in controlling “physical and psychological distress”. In such cases the last resort is “deep sedation”. This means putting the patient into a coma and is usually accompanied by the withdrawal of medication, nutrition and water. That may not be the choice of those who wish to protect their loved ones from a painful bedside vigil of several days.
Voluntary assisted dying offers the choice of death in a matter of minutes and maintains the “presence” of the patient until almost the end. I think that choice is valuable. – Yours, etc,
ALAN TUFFERY,
End of Life Ireland,
Raheny,
Dublin 5.