Who is popular today?

Irish society has a responsibility to offer the choice of medically assisted dying to those suffering with a terminal incurable illness, a network of 100 doctors has said.
In its submission to the Oireachtas justice committee which is considering Dying with Dignity Bill, the Irish Doctors supporting Medical Assistance in Dying (IdsMAiD) group writes that medically assisted dying can be introduced in a “safe and fair manner”. It argues that in cases of terminal illness, “patients deserve to have their choice respected”.
The Bill tabled by People Before Profit TD Gino Kenny, which seeks to legalise assisted dying, passed to committee stage last October after a vote in the Dáil.
The submission, signed by 100 doctors across Ireland, states the Bill’s criteria for qualifying for assisted dying is appropriately “conservative and restrictive” and that the safeguards proposed are “conservative, balanced and fair”.
Comprehensive regulation, monitoring and reporting of assisted dying must take place if the Bill passes to ensure accountability, transparency and to foster trust in the public, says the group.
However, it argues that the “hypothetical fears” that such legislation would harm Irish society are “insufficient reason to condemn people with terminal illness to unnecessary suffering”.
While palliative care can control and alleviate the symptoms of many patients, it “cannot eliminate all pain and suffering for all patients”, states the submission. “MaiD should be seen as complementing palliative care rather than any attempt to diminish it,” it states.
While the medical profession had traditionally opposed assisted dying, there is a “growing acceptance” among doctors that this is an “ethical issue for society to determine”, the group says.
The group supports the Bill’s provisions which state that assisted dying would only apply to competent adults, residents in Ireland and people with a terminal illness that is “progressive and incurable”.
It notes that a person should not qualify for assisted dying on the basis of a mental illness alone and further research is required before this is considered. Legislators should follow Canada and Victoria (Australia) by excluding mental illness as qualifying as a terminal illness to “eliminate any doubt or confusion on this issue”, it says.
Access to assisted dying for patients with advanced dementia remains an “evolving issue due to the need for advanced consent”, it adds.
In its recommendations to the Oireachtas, the group calls for comprehensive data collection, auditing and monitoring to ensure standards are being maintained and notes that patients should have a choice regarding how assisted dying takes place – through intravenous or oral medication. The patient’s underlying terminal condition should be certified as the cause of death in the death certificate, the group advises.
Members of the Irish Palliative Medicine Consultants’ Association (IPMCA) have criticised the wording of the Bill saying its definition of what constitutes a terminal illness is too broad.
IPMCA chair Dr Feargal Twomey said “the Bill as it stands was very open to significant misuse and abuse”.
Dr Brendan O’Shea, a Kildare GP who helped draft the submission, says assisted dying will never be relevant to most people who die in Ireland but that for a small number, it is a “vitally important” option. Dr O’Shea, assistant adjuvant professor in public health and primary care at Trinity College, said the Bill was currently “short on detail” but that he believes all missing elements would be drafted in as the legislation passes through the Oireachtas.
“We feel most strongly that details around regulation need to be discussed,” he said, adding that medical practitioners, scientific experts and the public should be consulted during the process.
Ireland should be guided by evidence from other countries who have had similar legislation in place for years, said Dr O’Shea. The Canadian model is “well-funded, well regulated and conservative in its approach” while the Dutch approach should also be carefully examined, he said.
Data from Canada and the Netherlands shows the legislation would be relevant for between 8-10 per cent of people who are dying and of these, less than four per cent will avail of the service, said Dr O’Shea.
Dr Brian Kennedy, who was also involved in the submission, says his time working as a palliative care doctor taught him about the importance of this compassionate form of patient care. “For the vast majority it is enough and most people in most circumstances can reframe to coping with live with their illness. But there are circumstances the patient, family and healthcare workers have to deal with which are simply too terrible for all concerned.”
Dr Kennedy believes offering the choice of assisted dying to terminally ill patients would help with Irish people’s “death anxiety” and is about putting the patient “front and centre”.