Dying with Dignity Bill


Sir, – We agree with many of Dr Miriam Colleran’s comments (Letters, July 9th), and value her insight as a respected specialist colleague in palliative care. Particularly, her final paragraph asserts the absolute importance of ongoing provision of compassionate and evidence based palliative care to all who need it, to which we would add that such care is not uniformly available throughout our health system. In particular, there are serious deficiencies in funding GP-delivered palliative care, which is a system-wide issue, and there are known gaps and regions where effective local access to specialist palliative care is lacking.

But the proposed legislation deals with a very different matter, and relates to a different treatment decision, that is medical assistance in dying, as opposed to palliative care. Evidence from the increasing number of jurisdictions where medical assistance in dying is available as a choice for people at end of life is that it is only finally chosen by circa 2 per cent to 4 per cent of all those dying. These are, in the main, people for whom it has not been possible to alleviate severe pain, less frequently a range of other very troublesome symptoms, or progressive profound disability, all in the context of a terminal illness.

Dr Colleran’s letter unfortunately somewhat creates an impression that medical assistance in dying will be practised on large numbers of people. In reality, the evidence clearly indicates that it is chosen by a few.

But in our opinion, they are an important few, and their position requires respect, not avoidance or dismissal. – Yours, etc,


Dublin 8;



Co Tipperary;



Co Mayo.