Monday, October 17, 2011

Forum 2011 on End of Life issues in Ireland

The Forum 2011 on End of Life in Ireland, held in Dublin on 12 October, was the culmination of two years of public consultation and meetings.   During this meeting, the Taoiseach, Enda Kenny, launched a new initiative called ‘Think Ahead’, which is aimed at encouraging people to write down arrangements and decisions with regard to their future life and health – a type of ‘Advance Care Directive’?    
(For further information on the Forum in general please see my previous blogs on the subject, e.g., 14 September 2011).

One contributor to the proceedings was a woman, three of whose children had been stillborn.  The theme of her talk was ‘Let us remember how once we dealt with death’, and she spoke of the way in which mothers, and their babies who died before, during or shortly after birth, were treated in maternity hospitals in the not too distant past.   She spoke, also, of the attitude of many – albeit not being intentionally hurtful – towards mothers, like herself, who had lost their babies.   Some people, thinking they were being helpful, would sympathise with her that she had not been able to hold her babies in her arms, as the hospital staff would spirit them away secretly and quietly.   The lady made a lovely statement about this.  She said that she did indeed hold her babies – ‘I held them in my womb for nine months.’  

Four workshop sessions were held during the afternoon.   One of these, ‘The Medicalisation of Dying’, was led by Professor Aidan Halligan, a former Deputy Chief Medical Officer for England.    In his introductory remarks, Professor Halligan spoke of the necessity to be personally present to patients – for instance, to hold their hands, to listen to what they had to say, rather than treating them as a number on a list.  A good doctor helps people to rediscover their lost values, and looks after someone because of who they are, with no discrimination.  ‘Do the right thing well on a difficult day’, Professor Halligan said.   A worrying note arose from his presentation, however, when he spoke of a project for the homeless in London that used the ‘Liverpool Care Pathway’ in its operation.   John Smeaton has written extensively on this  rather suspect programme.
Except for some implications arising from the references that were made to the advantages of ‘Advance Care Directives’, the general tone of the day appeared to be a positive one.    

However, when a query on assisted suicide was put by one of the attendees, the Chairman of the National Council of the Forum on End of Life, Mrs. Justice McGuinness (she chaired the meeting) replied that as assisted suicide is illegal in Ireland it is the policy of the Forum not to discuss the subject.    We sincerely hope that it will remain that way.