Legalisation of euthanasia would put severe pressures on vulnerable groups such as the elderly and the disabled, the Irish Association for Palliative Care warned yesterday at the launch of its position paper on the issue in Dublin.
The IAPC, which is the representative multi-professional body for those involved in the care of the dying, recommends that euthanasia should remain illegal.
"Voluntary euthanasia, if it were legalised, would have detrimental effects on patients, health care and society."
Personal autonomy, says the paper, must be balanced with the needs of society as a whole. The document was written by Dr Tony O'Brien, Marymount Hospice, Cork, and Dr Regina McQuillan, St Francis's Hospice, Raheny, Dublin - both consultants in palliative medicine - and Ms Hazel Smullen, clinical facilitator in the education department of Our Lady's Hospice on behalf of an IAPC ethics working group.
It endorses the right of the "competent, informed patient" to refuse medical investigation and treatment. When patients are unable to express opinions, healthcare professionals are obliged to "do the most positive good" for them. Basic principles of palliative care require that doctors offer their patients sufficient analgesics (pain killers) and other appropriate medication to ensure that they are comfortable and pain free.
It is recognised that for a variety of reasons a dying patient may experience restlessness and agitation: "the clinician must regularly reassess the patient in order to identify potentially reversible causes of this."
The paper refers to the "principle of proportionality", which affirms that life-prolonging treatments are contra-indicated when the suffering they cause outweighs the benefit.
It notes that both the Medical Council of Ireland and An Bord Altranais state in their guidelines that where death is imminent, it is the health professional's responsibility to ensure the patient dies with dignity.
The future development of palliative care services, says the IAPC, means ensuring they adequately address the needs and preferences of patients with cancer and other life-threatening illnesses.