Radio Scope The World Tonight: Assisted Dying BBC Radio 4, weeknights 10pm, Thursday, 11th May
Some months before his death, Dr Paddy Leahy told me of the emotional upset he experienced in helping people to die. Dr Leahy was the only Irish doctor to declare publicly that he had helped people to die who were undergoing great pain and suffering from a terminal illness.
He talked of the emotional torment involved in taking a train back to Dublin from a provincial town or city after helping someone to put an end to their suffering. He said he was not the only doctor who did this but he is certainly the only one to have come foreword.
I thought of Dr Leahy when listening to a Dutch doctor talking on The World Tonight about the emotional strain of helping people to die under the country's liberal euthanasia regime. It took a day to recover emotionally from each of these events, he said. He had performed euthanasia on nine people and it got harder every time.
But he was also haunted by the memory of a woman crippled with arthritis, to whom he refused euthanasia. Instead he organised everything from counselling to physiotherapy for her. But the woman starved herself to death under his care.
The World Tonight was covering the issue in the context of last week's vote in the House of Lords on a Bill to allow doctors to assist people to die. The passage of the Bill was blocked on Friday by an amendment. However, it may yet be reintroduced.
The Bill would not have allowed doctors to administer a fatal drug but it would have allowed them to give the patient sufficient medication with which to take his or her own life.
As the example from Holland suggests, this is not a simple issue. One woman interviewed has lung cancer and looks forward to dying but she does not want euthanasia.
"Wanting to die does not mean you want to kill yourself," she said. Instead, when the end is near, she will be given palliative sedation. What this means, the programme told us, is that she will go to sleep and she will never wake up.
I suspect I am not the only listener who wondered what, really, is the difference between euthanasia and palliative sedation.
And when a patient is admitted to an Irish hospital with a "do not resuscitate" note on their file, meaning they will not be resuscitated should they lose consciousness, how different is that from euthanasia? It is, of course, different, but how different?
In the Netherlands, one death in 40 is by euthanasia, according to the programme. That is a lot, and it suggests that very many people would accept this option to bring an end to suffering and loss of dignity - the two most commonly cited reasons for taking this step.
Those who oppose euthanasia would argue that the same effect could be achieved by ensuring that good palliative care was readily available to everybody with a terminal illness. Perhaps that is so. But almost two-thirds of those who die annually do so in a hospital or other institution. How much palliative care is given in these institutions and how reliable is that?
For many, death in a hospital is "good and dignified", according to the Irish Hospice Foundation. "Some, however, die in circumstances which are far from ideal and some die lonely, frightened and in pain."
The foundation promoting a "Hospice-friendly Hospital" programme to encourage the spread of good palliative care practices through the system. See www.newgrange-process.net/
The subject is complex, and painful and there are no clear answers. But at least the British are having a debate about it. Perhaps it is time we had the debate here.
pomorain@irish-times.ie
Padraig O'Morain is a journalist and counsellor.