The book strives for as complete and dispassionate a description of the situation as possible and covers in detail: the substantive law applicable to euthanasia, physician-assisted suicide, withholding and withdrawing treatment, use of pain relief in potentially lethal doses, terminal sedation, and termination of life without a request (in particular in the case of newborn babies); the process of legal development that has led to the current state of the law; the system of legal control and its operation in practice; and, the results of empirical research concerning actual medical practice.
There is evidence from outside the UK to show that physicians’ religious beliefs influence their decision making at the end of life. This UK study explores the belief system of consultants, nurse key workers & specialist registrars & their attitudes to decisions which commonly must be taken when caring for individuals who are dying. Results showed that consultants’ religion & belief systems differed from those of nurses & the population they served. Consultants & nurses had statistically significant differences in their attitudes to common end of life decisions with consultants more likely to continue hydration & not withdraw treatment. Nurses were more sympathetic to the idea of PAS for unbearable suffering. This study shows the variability in belief system and attitudes to end of life decision making both within and between clinical groups. The personal belief system of consultants was not shown to affect their overall attitudes to withdrawing life-sustaining treatment or PAS.
A national survey of 3733 UK doctors reporting on the care of 2923 people who had died under their care is reported here. Results show that there was no time to make an ‘end-of-life decision’ (deciding to provide, withdraw or withhold treatment) for 8.5% of those reporting deaths. A further 55.2% reported decisions which they estimated would not hasten death and 28.9% reported decisions they had expected to hasten death. A further 7.4% reported deaths where they had to some degree intended to hasten death. Where patients or someone else had made a request for a hastened death, doctors were more likely to report expecting or at least partly intending to hasten death. Doctors usually made these decisions in consultation with colleagues, relatives and, where feasible, with patients.
The House of Lords in Purdy forced the DPP to issue offence-specific guidance on assisted suicide, but Jacqueline A Laing argues that the resulting interim policy adopted last September is unconstitutional, discriminatory and illegal. In July 2009, the law lords in R (on the application of Purdy) v Director of Public Prosecutions [2009] All ER (D) 335 required that the DPP publish guidelines for those contemplating assisting another to commit suicide. The DPP produced a consultation paper (23 September 2009) seeking to achieve a public consensus, albeit outside Parliament, on the factors to be taken into account in determining when not to prosecute assisted suicide. Although the consultation exercise is hailed by proponents of legislative change as a democratic, consensus-building and autonomy-enhancing initiative, there is much to suggest that, on the contrary, the guidance is unconstitutional, arbitrary and at odds with human rights law, properly understood.
Figures obtained by The Daily Telegraph show that more than 30 people travelled to die with the help of Dignitas or Ex-International in 2009. At the same time, a high-profile campaign conducted in Parliament, the courts and the media sought to end the fear of prosecution for those who assist in suicides.
A man with "locked-in syndrome" has begun legal action, asking the director of public prosecutions to clarify the law on so-called mercy killing. Tony Nicklinson, 56, wants his wife to be allowed to help him die without the risk of being prosecuted for murder. Mr Nicklinson, of Chippenham, Wiltshire, communicates by blinking or nodding his head at letters on a board. His lawyers say he is "fed up with life" and does not wish to spend the next 20 years in this condition. According to his legal team, his only lawful means of ending his life is by starvation - refusing food and liquids. His wife Jane says she is prepared to inject him with a lethal dose of drugs, but this would leave her liable to be charged with murder.
Fergus Walsh | 20:30 UK time, Monday, 19 July 2010 The case of Tony Nicklinson will re-open the debate on assisted dying and so-called "mercy killing". He has locked-in syndrome, following a stroke. Unable to talk, he communicates by blinking or nodding his head. He also has a specially adapted computer with a push-button control. Mr Nicklinson wants his wife to be allowed to inject him with a lethal drugs dose without the fear of her being prosecuted for murder or manslaughter. As the law stands, that seems a vain hope because actively taking a life, even with consent, has always been treated as a crime, leading to a jury trial.
A 46-year-old-man who wants to die after a stroke that left him almost completely paralysed is bringing a groundbreaking legal action that could effectively lead to the legalisation of assisted suicide in the UK. Martin was a fit and active man who enjoyed rugby, cars and socialising with friends in the pub before suffering a brainstem stroke three years ago. Now requiring round-the-clock care, his mobility is limited to moving his eyes and small movements of his head. He communicates by staring at letters on a computer screen which the machine recognises and forms into words spoken by a digitised voice. Martin has been asking to die since six months after the stroke but says he has no one willing to assist him and cannot on his own organise a trip to the Swiss clinic Dignitas, where he could end his life legally. His wife, who chooses to be known as Felicity, says she will be with him if he dies but will not help bring about his death.
The total number of deaths studied was 11,704 of which 1517 involved continuous deep sedation. In Dutch hospitals, CDS was significantly less often provided (11%) compared with hospitals in Flanders (20%) and U.K. (17%). In U.K. home settings, CDS was more common (19%) than in Flanders (10%) or NL (8%). In NL in both settings, CDS more often involved benzodiazepines and lasted less than 24 hours. Physicians in Flanders combined CDS with a decision to provide physician-assisted death more often. Overall, men, younger patients, and patients with malignancies were more likely to receive CDS, although this was not always significant within each country. Conclusion Differences in the prevalence of continuous deep sedation appear to reflect complex legal, cultural, and organizational factors more than differences in patients’ characteristics or clinical profiles. Further
Dr Iain Kerr came under fire from Sir Graeme Catto, a former president of the General Medical Council (GMC) which registers UK doctors and now chairman of Dignity in Dying – a group which wants to give the terminally ill the option of killing themselves. Sir Graeme, who lives in Aberdeen, said he disapproved of the help Dr Kerr gave to elderly patients who were intent on suicide. Dr Kerr, who was a GP at Williamwood Medical Centre in Clarkston, East Renfrewshire, confessed to supplying sleeping tablets to a couple who wanted to end their lives together. He also revealed he had advised another pensioner how to use anti-depressants he was taking to kill himself and visited the patient while they took effect. Sir Graeme said: "Dignity in Dying is an organisation that is committed to working within the law to change the law. We simply do not condone healthcare professionals from medicine or nursing or any other group taking matters into their own hands. In Iain Kerr's case that is w...
He is not a typical campaigner. But behind his quiet manner is such a firm belief that assisted suicide should be legalised in Scotland that he has taken the extraordinary step of describing how as a GP he helped patients who wanted to end their lives. He did not embark on his medical career to do this. Instead, he said, he formed his views through reading and experience with patients over the years. Surprisingly he said Dame Cicely Saunders, credited with founding the hospice movement, made an impression on him early on. Dr Kerr, an atheist, is a volunteer driver for a hospice today. He said: "Cicely Saunders noticed doctors and nurses actually spent much less time with people with a terminal diagnosis and these people became more isolated as their needs increased. I think I was for a long time aware of the appropriateness of doctors discussing end-of-life issues or at least giving patients an opportunity to raise the subject."