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Explainer: Everything you need to know about the assisted dying bill set to come before the Dáil

New legislation could soon see assisted dying legalised in Ireland.

THIS WEEK, THE Dáil will debate a new bill which could legislate for assisted dying in Ireland if it is passed into law.

The bill, which has been tabled by People Before Profit TD Gino Kenny, aims to enable citizens to die with medical assistance if they are suffering from a terminal illness.

The practice is legal in several other countries and already has a number of high-profile proponents in Ireland, but is highly contentious and fraught with ethical dilemmas.

Here’s our crash course in what assisted dying means, the arguments for and against it, and what the proposed legislation entails.

What is assisted dying?

As the term suggests, assisted dying is the act of deliberately providing medical assistance to another person who wishes to end their own life.

For example, if a friend or relative of someone helps them to procure drugs in the knowledge that they intend to use those drugs to kill themselves, they would be engaging in the act of assisted dying. 

The practice differs from euthanasia, which is what happens when a second party intentionally ends someone’s life to relieve their suffering – like a doctor administering a lethal injection to someone who is terminally ill.

Helping someone take their own life is currently illegal under Irish law, while taking one’s life is not.

Under Section 2 of the Criminal Law (Suicide) Act 1993, anyone who “aids, abets, counsels or procures the suicide of another [person]” can be convicted and imprisoned for up to 14 years.

Last year, an Amárach/Claire Byrne Live poll for TheJournal.ie found that 55% of people think that assisted suicide should be legal in Ireland, with 22% of people opposed.

Why is it in the news?

A new bill which would legalise assisted dying, the Dying with Dignity Bill 2020, is set to come before the Dáil after being launched earlier this month.

The issue has made headlines already in recent years through the cases of Marie Fleming (who lost a Supreme Court appeal to establish a constitutional right to die) and Gail O’Rorke (who stood trial on charges that she tried to assist the suicide of her friend).

90286539 Marie Fleming, an assisted dying campaigner who died seven years ago Sam Boal / RollingNews.ie Sam Boal / RollingNews.ie / RollingNews.ie

Although it was initially expected that the bill would be defeated by the Government, there is now a real possibility that it could progress after the coalition parties last week signalled that a conscience vote could take place.

This is where TDs are allowed to vote on an issue according to their own personal conscience, rather than having to vote on an official line set down by their party.

Speeches in favour of a conscience vote were made by Fine Gael TDs and senators at a party meeting last Wednesday, before Green Party leader Eamon Ryan suggested he would allow a conscience vote on the proposed legislation on Thursday.

By Friday, Taoiseach Micheál Martin also indicated the possibility of a conscience vote among Fianna Fáil TDs, saying it was the party’s recent policy for votes on life or death issues.

What’s in the Dying with Dignity Bill?

According to its explanatory memorandum, the purpose of the bill is to “make provision for the assistance in achieving a dignified and peaceful end of life” in those who wish to die, particularly those who are suffering from a terminal illness.

It comprises 15 sections, which lay out who could seek assistance to die, the criteria under which they could do so, and rules around the role of those who would provide medical help for them.

Under the terms of the bill, a person could only seek assistance to die if they had a terminal illness, defined as one which is “incurable, progressive, and… which cannot be reversed by treatment”. This illness must be verified by two medical practitioners.

The person must also be aged 18 or over and resident in Ireland for at least a year.

Crucially, a person who says that they want assistance to end their own life must have the capacity to do so, something which would also be assessed by medical practitioners.

If a person meets these criteria and then wished to end their own life, they must state their clear intention to do so and sign a declaration in the presence of a witness, which would also have to be signed by two medical practitioners.

Neither of these practitioners could act as the person’s witness. In other words, the declaration will have to be signed by four people.

download (2) Oireachtas.ie Oireachtas.ie

Two weeks after the declaration becomes effective, a doctor would then prescribe substances to enable the person to end their own life.

A medical practitioner or their assistant (i.e. a nurse) could provide the person with these substances and help them to administer them and would have to remain with them until they took them or chose not to do so.

At all times, medical practitioners would have to take records, including a final declaration that the assisted dying has been carried out, no more than a week after the substance would be administered.

Safeguards

Given the moral considerations involved in the entire process, the bill also contains safeguards to ensure a person would be qualified to make a decision to end their own life.

The bill does not just contain criteria for the person who will die: there are provisions for conscientious objection for medical practitioners who are morally against assisting in a patient’s death.

If the bill became law, the roles of two medical practitioners, one of whom would have to be independent, would be central to the entire process.

The independent practitioner would not be able to be a relative, partner or colleague of the first practitioner (who would likely be the person’s own doctor).

At various stages, these practitioners would be relied upon to ensure everything – from the person’s medical condition to the transparency of their decision to end their own life – is above board.

At the first stage, the two medical practitioners would also have to verify the person’s terminal illness and assess their capacity to make the decision to end their own life. 

Those who cannot understand or retain information about ending their life or those who cannot communicate their decision to do so would not be allowed to request assistance.

So someone who is in a coma, for example, could not be deemed able to seek medical help to end their own life if the bill becomes law.

green 419 Eamon Ryan has indicated that he could allow a conscience vote on the issue among Green TDs Sam Boal / RollingNews.ie Sam Boal / RollingNews.ie / RollingNews.ie

Meanwhile, there would also be certain criteria around the person’s declaration.

As well as the two medical practitioners, the declaration would have to be signed by a witness, whom the bill specifically states must sign it in the presence of the person who wished to die.

This witness would also have to be someone who would not benefit from the person’s estate after their death.

Any of the four people who would sign the declaration could later revoke their signature, and they would not have to do so in writing.

Both medical practitioners would also have to be satisfied that the person seeking to die was fully informed of the palliative, hospice and other care available to them.

The person would then have to wait 14 days after the declaration became active – the date on which it is signed by the independent practitioner – before they could end their own life.

However, this would be reduced to six days if both medical practitioners believed that a person’s death from terminal illness could occur within one month of the day the declaration takes effect.

Finally, any substance that would be provided to the person who wished to die could only be delivered after an attending doctor confirmed the person had not revoked and did not wish to revoke their declaration.

If the person did decide not to take the substance, the medical practitioner would have to immediately take it away from them.

What do proponents of assisted dying say?

Most arguments in favour of assisted dying are either ethical or practical considerations focusing on compassion and personal liberty.

From an ethical standpoint, some proponents say that people should be allowed to choose how and when to end their own lives under the principle of free choice.

They say this is particularly true when a person wants to reduce their suffering due to a terminal illness, but can’t do so in a palliative setting or without facing additional suffering.

Some argue that those who are going to die anyway should be allowed to avoid the pain and anxiety that sometimes comes in the final months of terminal illnesses.

Where assisted dying is available, it’s argued that a person can have a more peaceful and dignified death than if they chose to end their own life outside a medical environment.

Others also suggest that many practices used in end-of-life care, such as palliative sedation (where a person is sedated with non-lethal drugs to ease their suffering) is a form of assisted dying, particularly as some sedatives can risk shortening a person’s lifespan.

What are the arguments against assisted dying?

As the safeguarding criteria in the proposed legislation shows, assisted dying is an extremely complicated process and there are worries that it could be open to abuse.

There are concerns that introducing the procedure could be a slippery slope and that it could progress from those who are terminally ill to other parts of the population – such as people with disabilities.

There are fears that vulnerable people could be coerced into agreeing to end their own lives, or that assessments of a person’s capacity to decide could fail.

Meanwhile, some have questions about whether assisted dying is a solution to suffering in a society that offers palliative care, where people can die in a dignified and painless manner.

There is another argument which asks whether more investment in this kind of treatment is required, rather than legislating for a process that is far more complicated.

Ethical considerations also play a part, as they do among proponents of assisted dying.

Many wonder whether helping a person to end their own life is any more moral than murder, while others have questioned if the practice is compatible with medical ethics and the role of doctors to heal, rather than harm, those they treat.

What happens next?

The Dying with Dignity Bill will be debated in the Dáil on Thursday, before TDs vote on whether it should proceed to committee stage for further oversight next week.

Sinn Féin, Labour, the Social Democrats and People Before Profit have all said they will vote in favour of the bill next week, but there are some Independent TDs who will not.

The three Government parties will likely confirm whether they will allow a free vote on the proposed legislation before Thursday’s debate – which could indicate how likely the possibility of assisted dying becomes in the next few years.

In the meantime, you can read the full bill for yourself here.

If you need to talk, support is available:

  • Samaritans 116 123 or email jo@samaritans.ie
  • Aware 1800 80 48 48 (depression, anxiety)
  • Pieta House 1800 247 247 or email mary@pieta.ie (suicide, self-harm)
  • Teen-Line Ireland 1800 833 634 (for ages 13 to 19)
  • Childline 1800 66 66 66 (for under 18s)

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    Mute Peter Denham
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    Sep 29th 2020, 12:15 AM

    This is welcome.

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    Mute Peter Denham
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    Sep 29th 2020, 12:18 AM

    @Peter Denham: I have seen first hand the pain, fear and confusion that comes with the latter stages of terminal illness. Let people chose when to go.

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    Mute Tony Gordon
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    Sep 29th 2020, 12:21 AM

    @Peter Denham: more than welcome, should have been available a long time ago

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    Mute Seán O'Loughlin
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    Sep 29th 2020, 1:00 AM

    I believe this should become legal.

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    Mute Sam Greene
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    Sep 29th 2020, 1:12 AM

    My sister passed away with motor nurone disease. She talked about how she wished she could choose the time to go, broke our hearts to see a beautiful intelligent woman suffer so much. It was her life, should have been her choice.

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    Mute EillieEs
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    Sep 29th 2020, 6:55 AM

    @Sam Greene: it’s a horrible illness, must have been heartbreaking to see your sister suffer. Hope you’re doing ok

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    Mute Ian Hoey
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    Sep 29th 2020, 9:35 AM

    @Sam Greene: Such a cruel cruel illness. I absolutely agree that people should have the right to choose.

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    Mute Paul Mc
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    Sep 29th 2020, 12:27 AM

    About time, If anyone has been with parents or friends on their death bed suffering from excruciating pain ,it’s not nice to watch and it’s only correct that people of sound mind should be giving the option of going asleep with a good dose of morphine.

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    Mute PaulOMahoney Irish
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    Sep 29th 2020, 7:44 AM

    As now a cancer survivor I must say this needs to happen. I have witnessed the pain of people watching loved ones slowly having less life in them and thats very difficult.
    Obviously this should be the patients choice if my cancer comes back I have decided with my wife’s approval not to seek further treatment and be allowed to pass, we have already made enquiries in Europe for assisted death. I’d rather be here in my country.
    Its a difficult decision and I don’t think anyone takes it lightly, no doubt there will be headbangers posting claptrap on this but remember its my body, my life and my decision.
    Now to the garden

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    Mute Padraig Corcoran
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    Sep 29th 2020, 12:21 AM

    Gino Kenny did not even know the details that are in the bill in a recent radio interview. He insisted that details were included that simply are not. No doubt it will pass as we seen how our elected politicians let what happened occur in the nursing homes recently.

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    Mute Paul Smith
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    Sep 29th 2020, 1:41 AM

    @Padraig Corcoran: Did am essay in my GCSE religion that I was all for euthanasia, best essay I ever wrote and got an F. Repeated it the following year, same question. Said I was totally against it. Got an A. Catholic schools don’t reflect people’s real opinions. If I was suffering I would like to go in peace.

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    Mute EillieEs
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    Sep 29th 2020, 8:09 AM

    @Padraig Corcoran: I didn’t hear the interview, what details did he get wrong?

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    Mute Padraig Corcoran
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    Sep 29th 2020, 8:31 AM

    @EillieEs: You should look it up. With Pat Kenny I think. He insisted on numerous occasions the patient would need to be in unbearable pain which his opposite in the interview pointed it it was not.

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    Mute Mary N. Cooke
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    Sep 29th 2020, 9:49 AM

    @Padraig Corcoran:
    I dont know anything about this Gino Kenny chap but I do think very strongly that you are missing totally the point of all this and throwaway comments re a pandemic and what the government is and was trying to do even though they didnt manage to know everything is comparing syringes and saucepans.

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    Mute Padraig Corcoran
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    Sep 29th 2020, 5:17 PM

    @Mary N. Cooke: Hey Mary I am pretty sure you don’t know me so you don’t know that how the government “looked after” those in our nursing homes during this pandemic is a throw away comment at all. Yes there is a pandemic sweeping the world right now yet they have time to put something like this forward. You should listen to the interview then read the Bill and make your own conclusions.

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    Mute Scorcher Bois Gris
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    Sep 29th 2020, 7:56 AM

    Delighted to see this bill being introduced- time to allow people a modicum of dignity and relief from suffering. As some have said, we treat animals better than humans when they’re in terrible pain and suffering.

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    Mute Iris Weber
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    Feb 7th 2021, 3:01 AM

    @Scorcher Bois Gris: Certainly animals are treated much better than children. As someone tortured as a child, never received any help. Still don’t no government help, crippled physically and emotionally. While old torturers get preferential vaccines.Fascinating. Look forward to being not on planet anymore.

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    Mute Pharmy
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    Sep 29th 2020, 4:25 AM

    The right to conscientious objection & non-participation is enshrined in the Irish constitution, and the EU and UN declarations on human rights. Nonetheless, this right was specifically denied to pharmacists in the termination of pregnancy act. If our government holds true to form we will again be denied our rights in this act. It would be nice if society stopped treating us like mindless vending machines and recognised what we bring to the table in caring for the sick and dying. The profession will continue to loose caring professionals if you don’t.

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    Mute Susan Scanlan
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    Sep 29th 2020, 10:09 AM

    My husband died in 2015 when our little girls were 3 and 5….he died slowly and in uncontrollable pain despite the wonderful support from the palliative care team and the pain management consultant. The bill must pass. No one should be screaming in pain in their final days.

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    Mute PaulOMahoney Irish
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    Sep 29th 2020, 11:43 AM

    @Susan Scanlan: Brave woman. Susan I really hope you have found a little bit of peace in your life and your girls are thriving.
    As I posted earlier I too hope that this bill passes, your husband is one of many many who needlessly suffered.

    Take care

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    Mute Susan Scanlan
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    Sep 29th 2020, 1:06 PM

    @PaulOMahoney Irish awww thanks, and after a horrific couple of years I picked myself up, left my job, moved house to the country side and am now a 4th year student in psychotherapy

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    Mute Susan Scanlan
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    Sep 29th 2020, 1:06 PM

    @PaulOMahoney Irish awww thanks, and after a horrific couple of years I picked myself up, left my job, moved house to the country side and am now a 4th year student in psychotherapy

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    Mute Susan Scanlan
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    Sep 29th 2020, 1:06 PM

    @PaulOMahoney Irish awww thanks, and after a horrific couple of years I picked myself up, left my job, moved house to the country side and am now a 4th year student in psychotherapy

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    Mute Ludie Creech
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    Sep 29th 2020, 6:42 AM

    Worst idea since repealing the 8th.

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    Mute Colm Garvey
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    Sep 29th 2020, 7:13 AM

    @Ludie Creech: Watch your father die a slow, agonising death of cancer over the course of months, withering away before your eyes, growing more and more resistant to morphine until eventually he’s taking a dose that would knock out a rhino just to manage the pain and then tell me what a terrible idea it is.

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    Mute Lorraine Mac Rory
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    Sep 29th 2020, 7:25 AM

    @Ludie Creech: what Colm said

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    Mute Robert O’H
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    Sep 29th 2020, 7:47 AM

    @Ludie Creech: Best idea since repealing the 8th more like.

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    Mute Dearbhla O Reilly
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    Sep 29th 2020, 7:48 AM

    @Ludie Creech: repealing the with was a great idea. And you cant change that by whining.

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    Mute JustBEERbarry
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    Sep 29th 2020, 9:20 AM

    @Ludie Creech: the one time dominant Catholic Church in Ireland is on its knees. Chin up. Time to move into the current era, padre.

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    Mute Susan Scanlan
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    Sep 29th 2020, 10:14 AM

    @Colm Garvey: my husband died slowly and horribly and despite 5 pain pumps he was still suffering terribly…….I’m so sorry your Dad suffered the same. This bill is full of compassion….your so right, people don’t understand

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    Mute Susan Scanlan
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    Sep 29th 2020, 10:18 AM

    @Ludie Creech: I watched my husband die slowly and in horrific pain and despite the support of pain management consultants and the palliative care team attaching 5 morphine pumps he still screamed. This bill is not a bad idea. I do however feel the elderly and vulnerable need to be protected, but if your terminally ill and screaming in pain why should that continue?

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    Mute Ludie Creech
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    Sep 29th 2020, 9:16 PM

    @JustBEERbarry: ah, yes. Progress. All in the name of progress.

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    Mute Ludie Creech
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    Sep 29th 2020, 9:16 PM

    @JustBEERbarry: and, by the way, no love lost for the Catholic Church. My comment is merely based on a high regard for the sanctity of life.

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    Mute Ludie Creech
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    Sep 29th 2020, 9:19 PM

    @Susan Scanlan: Susan, I am so very sorry for your loss, and the grief you had to endure. Ultimately, however, I’m a staunch defender of the sanctity of life- all life- unborn, and that which is coming to an end. God is the giver of life, and man should stand clear of “playing God” in these situations. I truly am sorry for your and your family’s immeasurable pain.

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    Mute Ludie Creech
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    Sep 29th 2020, 9:19 PM

    @Dearbhla O Reilly: oh, ok.

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    Mute Ludie Creech
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    Sep 29th 2020, 9:22 PM

    @Colm Garvey: Colm, I’m very sorry for your loss. I too have endured watching loved ones waste away. However, I hold that life is precious, and given by God, and to be ended only by God, whether unborn or ending due to disease or illness. Again, I’m deeply sorry for your pain and loss watching your loved one suffer.

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    Mute Ian Hoey
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    Sep 29th 2020, 9:43 AM

    I think it’s a no brainer that this should pass. If you don’t agree with it, you won’t use the option. Everyone should have the right to choose. If this goes to a referendum, it will be unanimously passed.

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    Mute Keith McDonagh
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    Sep 29th 2020, 8:44 AM

    If it’s what someone wants, they should be allowed access to it. There should be nothing or no one stopping them.

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    Mute London-Irish Senator
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    Sep 29th 2020, 9:10 AM

    What TD was elected on this platform? None ! Because the majority of people don’t support it. Therefore why should such a bill be presented in the Dail…

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    Mute JustBEERbarry
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    Sep 29th 2020, 9:36 AM

    @London-Irish Senator: the majority don’t support it? Really? Let’s see.

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    Mute Susan Scanlan
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    Sep 29th 2020, 10:23 AM

    @London-Irish Senator: my husband died slowly and screaming in uncontrollable pain. Despite 5 morphine pain pumps attached to him and a team of pain management professionals caring for him. This bill must pass

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    Mute Sean Salmon
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    Sep 29th 2020, 8:14 AM

    What is the difference between the pain torment and suffering experienced by a young person contemplating suicide and an older person thinking the same? There is no real compassion in finishing off the elderly while we bemoan the horror of suicide generally

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    Mute Benny McHale
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    Sep 29th 2020, 8:35 AM

    @Sean Salmon: Don’t think they’re talking about a healthy person that’s tired of living or is depressed. It’s about someone with a terminal illness that’s going to die anyway. This way, they can be spared the indignity and pain of having a horrendous lead up to their death.

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    Mute Nick Caffrey
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    Sep 29th 2020, 8:59 AM

    @Sean Salmon: Try to understand what the article is saying. Knee-jerk reactions are rarely intelligent.

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    Mute Susan Scanlan
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    Sep 29th 2020, 10:12 AM

    @Sean Salmon: it’s not just elderly, my husband died in 2015 , the pain became utterly uncontrollable and despite the 5 pain pumps attached to him he still screamed…..and screamed……the elderly and vulnerable who are not in uncontrollable pain should be protected. But no soul should die how Colm did.

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    Mute Sean Salmon
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    Sep 29th 2020, 10:59 AM

    @Susan Scanlan: I accept that uncontrollable pain is horrid but if you think that this bill will not have massive abuse or become more liberal as time passes. Look at Canada

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    Mute Sean Salmon
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    Sep 29th 2020, 11:01 AM

    @Benny McHale: a seriously depressed person is not a healthy person.

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    Mute Iris Weber
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    Feb 7th 2021, 3:13 AM

    @Sean Salmon: “Finishing off ” the elderly…I was tortured by birth giver half my life, crippled, alone, yet the female who did this is “entitled” to vaccine before me…WHO is being finished off, I wonder ???

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    Mute Tom Mullally
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    Sep 29th 2020, 8:11 AM

    If breaking the commandment thou shall not kill is a mortal sin which would result in a person going to hell then it would not be considered compassionate to help someone to escape a short period of suffering in this life compared to eternal suffering in the next

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    Mute Sinead Boland
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    Sep 29th 2020, 8:26 AM

    @Tom Mullally: I’m not religious, I’d like the choice

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    Mute P Mc G
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    Sep 29th 2020, 8:33 AM

    @Tom Mullally: That’s your belief, not everyones. You’re entitled to have your own thoughts. You are entitled to follow whichever of the thousands of religions there are that you like. But the days of religion bring the prime argument in decision making are no more.

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    Mute JustBEERbarry
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    Sep 29th 2020, 9:22 AM

    @Tom Mullally: here we go again, the anti choice brigade are up

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    Mute PaulOMahoney Irish
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    Sep 29th 2020, 11:47 AM

    @Tom Mullally: Theres alway the few……kindly remove you nose from other peoples lives. Christianity has a lot more to give than 10 commandments that were sent down, allegedly, long before Christ was on this earth.
    Please let us control our lives, its a Christian thing to do.

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    Mute Tom Mullally
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    Sep 29th 2020, 1:31 PM

    @PaulOMahoney Irish: it’s the Christian thing to not just save ourselves from going to hell but to try to stop others going there.

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    Mute marianne ryan
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    Sep 30th 2020, 12:48 PM

    Have seen people suffer with dementia and know i do not want to suffer like that, should be allowed put it in your will should there be no cure that you wish to be helped pass away.

    3
    Install the app to use these features.
    Mute Eric Dignan
    Favourite Eric Dignan
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    Oct 8th 2020, 10:22 PM

    @marianne ryan: unfortunately a dementia diagnosis will prevent people from availing of this

    1
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