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Assisted Dying

HSE tells Assisted Dying Committee there are already 'significant' supports for 'dying in a dignified way'

The final public session of the committee convened this morning.

THE HSE HAS told TDs and senators considering a policy recommendation on assisted dying that Ireland already has “significant” supports in place to help people “die in a dignified way”.

The final public session of the Oireachtas Committee on Assisted Dying convened this morning to hear from representatives of the HSE and the Department of Health, which would both have important roles in implementing legislation on assisted dying if the government decided to move on the matter.

Over a series of meetings, the committee of TDs and senators has heard submissions from patients and a range of organisations about assisted dying, which have spanned a broad spectrum of views in favour and against the practice.

Dr Siobhán Ní Bhriain, the HSE’s National Clinical Director for Integrated Care, told the committee in her opening statement that “it is the conclusion of the senior clinical group in the HSE that there are significant supports, both legal and medical, in place in Ireland to enable people to die in a dignified way”. 

The HSE offered a list of matters related to assisted dying that it said clinicians believe need consideration.

Ní Bhriain said that vulnerable people might be at particular risk of viewing themselves as a burden or of being coerced, and these people could be at risk of feeling undue pressure to consider assisted dying.

There is also a risk, it said, around how thoroughly patients with illnesses like cancer or life-limiting conditions who experience suicidal thoughts would be examined and treated for mental illnesses.

It raised patient safety concerns, saying there is a risk that someone could choose to seek assistance with dying but more robust investigation into their illness or time to consider their diagnosis and treatment options might have resulted in them making a different choice.

Healthcare workers, too, could be impacted if having to make a decision about assisted dying or a patient going through a painful and prolonged death could violate their own core values and harm that psychological and emotional wellbeing, the HSE said.

The Department of Health, in its representation, said it is currently finalising a new palliative care policy for adults that will “reflect the many developments in end-of-life care and international best practice, as well as setting out a vision and roadmap to meet future service needs”.

“The new policy will provide for a better integration of services in a patient-centred manner, reducing anxiety and stress during illness and death for our most vulnerable citizens,” Assistant Secretary Siobhán McArdle said in the department’s opening statement.

Both the HSE and the department stopped short of explicitly giving a position on whether legislation should or should not be introduced to permit the practice of assisted dying, to the frustration of some of the politicians present.

The HSE said it could not give “definitive commentary” on the exact requirements for implementing a policy on assisted dying as there is no existing legislation on it.

Similarly, the Department of Health said it has no policy position on the matter because it falls outside of existing health policy.

It also said it has not commissioned research on assisted dying, adding that research is typically commissioned only when the government has made a request for a particular policy.

People Before Profit TD Gino Kenny, who has been a strong supporter of legislating for assisted dying, said that it is a complicated issue but that he believes the complexities can be overcome.

“We shouldn’t conflate palliative care with assisted dying. I believe that they can be complementary,” he said, adding it should be a “fundamental human right” for people to “die on their own terms”.

He said some of the language in the HSE’s opening statement was “disappointing” and that he believes conflating the matters of assisted dying and suicide is “unhelpful”.

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