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Tuesday 23 January 2018

Right-to-die case woman carrying 'striking' burden, says palliative-care expert

Marie Fleming
Marie Fleming

Dearbhail McDonald Legal Editor

A MULTIPLE sclerosis sufferer who is challenging Ireland's ban on assisted suicide is carrying a ‘striking’ burden, according to one of Ireland's leading palliative-care experts.

But the quality of life of Marie Fleming could be "greatly enhanced and significantly improved" by active engagement with palliative care professionals, the High Court has heard.

Dr Tony O'Brien, who is a physician in palliative medicine at Cork University Hospital, said that he feared any law to Ireland's ban on assisted suicide could adversely affect vulnerable people.

Dr O'Brien, who chaired the Council of Europe Expert Committee on palliative care, is giving evidence before a specially convened three-judge High Court in the case of Marie Fleming, who is in the final stages of MS.

He said it appeared that Ms Fleming was experiencing a "great level of distress".

However, he added that that he believed the 58-year-old grandmother's life could be "greatly enhanced and significantly improved" by active engagement with palliative care professionals and consultant led pain services.

Dr O'Brien said that Ms Fleming's underlying condition cannot be cured but insisted the philosophy of palliative medicine is that "there is always something more to be done".

He drew comfort from the legal position in Ireland which states that it is wrong to engage in any act designed or intended to bring about the death of a patient.

"The beauty of the current (legal) situation is that it is clear. I am fearful that if we start modifying that and making exceptions, it will significantly muddy the waters".

The view that palliative care medicine meant that a patient had to be rendered comatose to subdue pain was "sadly, completely incorrect", said Dr O'Brien, adding that cognitive dysfunction is not something that he sees in his day to day practice.

The controlled and carefully balanced use of opiates such as morphine can benefit lives without loss of consciousness, he added.

"Ireland has a very long and proud tradition in terms of palliative care," Dr O'Brien told Senior Counsel Shane Murphy.

Dr O'Brien has been called as a State witness in the landmark action challenging Ireland's complete ban on assisted suicide.

He said that some patients fear the process of dying and what happens after death - "what one can expect on the other side".

"This (fear of dying) is something that needs to be carefully managed," said Dr O'Brien who said that there is no reason to believe that patients with MS and Motor Neurone Disease cannot manage that fear provided those around them such as family are supported and can manage that.

Ms Fleming wants orders allowing her to be lawfully assisted in taking her own life at a time of her choosing.

She also argues that the DPP is required to outline the factors in deciding whether to prosecute cases of assisted suicide, which carries a maximum 14-year jail term.

The case is due to conclude tomorrow.

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