Pregnant women who ask for a Caesarean delivery should be allowed to have the operation, even if there is no medical need, according to new guidelines for England and Wales. The National Institute of Health and Clinical Excellence (NICE) states that women should be offered counselling and told of the risks first. Ultimately, however, the decision would be made by the mother-to-be, it said.
Most senior doctors in England and Wales feel that rational suicide is possible. There was no association with specialty. Strong religious belief was associated with disagreement, although levels of agreement were still high in people reporting the strongest religious belief. Most doctors who were opposed to physician assisted suicide believed that rational suicide was possible, suggesting that some medical opposition is best explained by other factors such as concerns of assessment and protection of vulnerable patients.
Tom Condliff, who weighs 22st, was not considered fat enough to have a gastric bypass operation by his local Primary Care Trust and both the High Court and the Appeal Court ruled that its decision was lawful. But less than a month after his latest setback, the 62 year-old from Staffordshire has been told that his latest “individual funding request” has been successful on the grounds of his exceptional circumstances and he will now be treated. He told the BBC: “I am very, very pleased about the PCT's decision but at the same time I am rather concerned that I haven't changed since the last time the request for IFR in September last year, was put in. “It was turned down then. So I don't know why it has been granted this time. “I am looking forward to being able to get out of the house and to enjoying myself and having a decent quality of life.”
My name is Geraldine McClelland and I have chosen to die today [7 December]. I am 61 years old and am dying from lung and liver cancer, which metastasised from my breast cancer two years ago. The lung cancer is now causing me serious breathing problems, meaning I am largely confined to my flat. I have chosen to travel abroad to die because I can not have the death I want here in the UK. I would like to be able to choose to take medication to end my life if my suffering becomes unbearable for me, at home, with my family and friends around me. But the law in this country prevents me from doing so. As a result I am travelling abroad to take advantage of Switzerland's compassionate law.
“The current legal status of assisted dying is inadequate and incoherent...” The Commission on Assisted Dying was set up in September 2010 to consider whether the current legal and policy approach to assisted dying in England and Wales is fit for purpose. In addition to evaluating the strengths and weaknesses of the legal status quo, the Commission also set out to explore the question of what a framework for assisted dying might look like, if such a system were to be implemented in the UK, and what approach to assisted dying might be most acceptable to health and social care professionals and to the general public.
A woman died after an experienced surgeon unintentionally attempted to take out the wrong organ during an operating theatre complication. Amy Joyce Francis, 77, was due to have a kidney removed at the Royal Gwent Hospital in July 2010 but instead the surgeon tried to remove her liver. The woman from Newport suffered a fatal heart attack after a loss of blood. The coroner recorded a narrative verdict which was fully accepted by the Aneurin Bevan Health Board.
The treatment of inherited mitochondrial abnormalities in human embryos using donor mitochondria is an advancing area of research. The techniques involved could have profound implications for future generations. This project will explore the ethical issues relevant to affected families, potential donors, researchers, medical professionals and others trying to understand and respond to the therapeutic possibility of mitochondrial transfer.
A man who was virtually paralysed by a stroke has won the first step in his legal bid to pursue his right-to-die. Known only as Martin, he would require professionals to help as his wife has said she will not assist him. But current guidance suggests they may be prosecuted, where loved ones would not, and Martin's case is this discriminates against him. This High Court judgement means lawyers and doctors can discuss assisted dying with him, but only to prepare his case.
The Commission on Assisted Dying, set up in September 2010 and chaired by former Lord Chancellor Charles Falconer, has issued its monumental report on assisted dying in England and Wales. The Commission was funded by two supporters of assisted suicide, author Terry Pratchett and businessman Bernard Lewis, and despite reassurances that the running and outcome of the Commission were independent, some individuals and groups opposed to the practice regrettably refused to give evidence to the Commission. Still, the range and quantity of the evidence, which included evidence gathered from international research visits, qualitative interviews and focus groups, commissioned papers, and seminars, is impressive and can be read and watched here.
W (by her litigation friend, B) v M (by her litigation friend, the Official Solicitor) and others [2011] EWHC 2443 (Fam). Read judgment. In the first case of its kind, the Court of Protection ruled that withdrawing artificial nutrition and hydration from a person in a minimally conscious state was not, in the circumstances, in that person’s best interests. The Court also made general observations for future cases.
The General Medical Council is consulting on our new draft guidance for the Investigation Committee and case examiners (decision-makers) to use when they are considering allegations about a doctor’s fitness to practise that relate to encouraging or assisting suicide.
Judgment has been reserved in a case brought by a severely disabled man with "locked-in syndrome" who has urged a judge not to halt his High Court action to let a doctor end his life. Tony Nicklinson, 57, of Melksham, Wiltshire, wants a doctor to be able to "lawfully" conduct an assisted suicide.
Two senior judges ruled it would be “manifestly unjust” to stop them helping him prepare a legal challenge to the law on assisted suicide – even if doing so could assist his suicide, which would be illegal. Once a keen sportsman, the man – known only as “Martin” for legal reasons – was left almost completely paralysed by a massive stroke three years ago.
When faced with a terminal illness, medical professionals, who know the limits of modern medicine, often opt out of life-prolonging treatment. An American doctor explains why the best death can be the least medicated – and the art of dying peacefully, at home
This report documents changes since the ODT 2008 report. It records significant improvements that have been made to infrastructure and projected 34% increase in donation rates over 4 yrs to April 2012. The report notes, however, that even if Taskforce’s target of a 50% increase in donation rates by 2013 is achieved, people will still be dying unnecessarily while waiting for an organ. We believe that we now need to decide whether we should be satisfied that we have done all we can or whether we should seek to build on what has already been achieved by shifting our attention to additional ways of increasing number of organ donors. The report examines a range of options that have been suggested for increasing the number of donors including a system of mandated choice, reciprocity, a regulated market or paying the funeral expenses of those who sign up to the ODR and subsequently donate organs. The report also explains why we remain convinced that an opt-out system with safeguards is best.
Guidance for the Investigation Committee and case examiners when considering allegations about a doctor’s involvement in encouraging or assisting suicide. Draft for consultation Start: Feb 6, 2012 End: May 4, 2012 Results Published: Jul 31, 2012
The General Medical Council is launching its first ever guidelines on assisted suicide. The new guidelines will help the GMC decide if doctors should face a disciplinary panel if they are alleged to have encouraged or assisted suicide. A draft version is to be subject to a three month public consultation period. The GMC's chief executive, Niall Dickson said "the main message is that assisting suicide is illegal and doctors should have no part of it". The GMC, which is the regulatory authority for doctors, decided to produce the guidelines after the case of a severely paralysed man, which was highlighted by the BBC last summer. The man, given the pseudonym "Martin", told the PM Programme that he wanted to end his life and was taking legal action to try to get advice and help to do so.
On 1 April 2005, with the implementation of the Human Fertilisation and Embryology Authority (Disclosure of Donor Information) Regulations 2004, United Kingdom law was changed to allow children born through gamete donation to access details identifying the donor. Drawing on trends in adoption law, the decision to abolish donor anonymity was strongly influenced by a discourse that asserted the ‘child's right to personal identity’. Through examination of the donor anonymity debate in the public realm, while adopting a social constructionist approach, this article discusses how donor anonymity has been defined as a social problem that requires a regulative response. It focuses on the child's ‘right to personal identity’ claims, and discusses the genetic essentialism behind these claims. By basing its assumptions on an adoption analogy, United Kingdom law ascribes a social meaning to the genetic relatedness between gamete donors and the offspring.
In 2007, the European Union adopted a lex specialis, Regulation (EC) No. 1394/2007 on advanced therapy medicinal products (ATMPs), a new legal category of medical product in regenerative medicine. The regulation applies to ATMPs prepared industrially or manufactured by a method involving an industrial process. It also provides a hospital exemption, which means that medicinal products not regulated by EU law do not benefit from a harmonized regime across the European Union but have to respect national laws. This article describes the recent EU laws, and contrasts two national regimes, asking how France and the United Kingdom regulate ATMPs which do and do not fall under the scope of Regulation (EC) No. 1394/2007. What are the different legal categories and their enforceable regimes, and how does the evolution of these highly complex regimes interact with the material world of regenerative medicine and the regulatory bodies and socioeconomic actors participating in it?
Penney Lewis, a law professor at King's College London, said the U.K. had become more receptive to allowing assisted suicide in recent years but not euthanasia. "Granting Nicklinson a hearing does not mean euthanasia will be allowed, but it is a big step," she said. Legalizing euthanasia in the Netherlands began in a similar fashion, with doctors in court cases employing arguments much like those of Nicklinson's legal team, Lewis said.
According to a BBC report, Tony Nicklinson, 58, from Melksham, Wiltshire, has “locked-in syndrome” after a stroke in 2005 and “is unable to carry out his own suicide.” “He is seeking legal protection for any doctor who helps him end his life.” In fact, it is not quite correct that Tony Nicklinson “is unable to carry out his own suicide.” He could at present refuse to eat food or drink fluids. Hunger strikers do this for political reasons. He could do it for personal reasons. People should not be force fed against their own autonomous wishes.
The paper discusses the issue of family involvement in the process of obtaining consent to treatment. Legally, doctors have a duty to inform the patient, and the patient has a right to be informed before making a decision. In this context, however, there is no requirement to involve relatives or to take into account their interests or requests. Yet, findings from in-depth interviews with NHS general practitioners presented in the paper indicate that in reality relatives have a substantial impact on the process of informed consent. Their presence may lead the doctor to provide more information to the patient and help the patient better understand the information conveyed by the doctor. Ultimately, the relatives' involvement enhances the patient's ability to make an informed decision, even though in some cases – when the relative is dominant – this may have a negative impact on the channel of communication between doctor and patient. These findings reflect a relational approach to patien
In circumstances where life-sustaining treatment appears merely to be drawing out the inevitable, it is usual practice for the healthcare team to withdraw aggressive life-sustaining measures, once agreement is reached with the patient and their family. Common law gives doctors several defences to allegations of criminality or malpractice in taking the key actions that withdraw treatment and result in the patient's death; however, the legal defensibility of nurses undertaking this role has not been explored. In the absence of a specific body of law related to nurses taking the actions that withdraw life-sustaining treatment, I discuss the probable legal response by consideri
Dignity in Dying has today welcomed MPs' historic decision to back Director of Public Prosecutions (DPP) guidelines on assisted suicide, as well as MPs endorsement of further development of end-of-life care via an amendment to the motion. The DPPs guidelines make clear that those who compassionately assist a loved one to die at their request are unlikely to be prosecuted, and that those who maliciously encourage the death of another will feel the full force of the law.
'Living wills' that stipulate exactly how a person wants to die should be drawn up with absolute clarity, a judge has ruled after concluding a 67-year-old man with motor neurone disease had made a "valid decision" to refuse treatment.
Terminally ill patients who want to commit suicide should be able to receive medical help to die, a government adviser on care for the elderly has said. Martin Green, a dementia expert for the Department of Health, said patients who were too frail to take their own lives were being denied “choice” and “autonomy” because assisted suicide is illegal in the UK. In an interview with The Daily Telegraph, he urged ministers to review the law and suggested that a referendum or a free vote in Parliament should be called to settle policy on the issue. “If you’re going to give people ‘choice’, it should extend to whether or not they want to die,” he said.
'A new pathway for the regulation and governance of health research' was published in January 2011. The report was prepared by a working group, chaired by Professor Sir Michael Rawlins FMedSci, convened in response to an invitation from Government to review the regulation and governance of UK health research involving human participants, their tissue or their data. The report proposes four key principles that should underpin the regulation and governance framework around health research in the UK, and makes recommendations to: * Create a new Health Research Agency (HRA) to rationalise the regulation and governance of all health research. * Include within the HRA a new National Research Governance Service to facilitate timely approval of research studies by NHS Trusts. * Improve the UK environment for clinical trials. * Provide access to patient data that protects individual interests and allows approved research to proceed effectively. * Embed a culture that value
A man who is almost completely paralysed is taking legal action in a bid to end his life. His solicitors have told the BBC that they believe his case could have major implications for the way prosecutors in England, Wales and Northern Ireland deal with assisted suicides.
Frances Swaine and Merry Varney are instructed by David Tracey, whose wife, Janet Tracey, sadly died in Addenbrooke’s Hospital on 7 March 2011. Following her admission to Addenbrooke’s, a ‘Do Not Attempt Cardio Pulmonary Resuscitation Order’ (known as a DNACPR or DNR) was placed on Janet’s medical notes. Janet was unaware of the DNACPR and when she became aware of it several days later, she clearly stated it was against her wishes and that she wanted to be resuscitated. As a result the DNACPR was cancelled. Several days later however a further DNACPR was entered onto her records. We have issued a judicial review and human rights claim against the NHS Trust responsible for Addenbrooke’s and against the Secretary of State for Health seeking Declarations from the Court that the Trust’s policy on the use of DNACPR is unlawful, and for the Secretary of State for Health to issue national guidance for patients and their families to know their rights concerning the use of DNACPRs.
In 2009 the legislature, judges & DPP each turned their attention to issues around assisted suicide. The legislature decided not to change the law. The judges decided the existing law was insufficiently clear & required the DPP to clarify it. The DPP flirted with reforming the law, but then drew back from such a legislative role. His published policy has been considered as a contribution to the regulation of death & dying, & as such has been found wanting. However, considered in the context of the proper roles of Parliament, courts & prosecutors, & seen as an exercise in constitutional restraint, the DPP's approach should be appraised rather differently. From this perspective, the decision of the HL in Purdy raises significant concerns for the legitimacy of decision making in the contested moral issues that arise in healthcare ethics. In our democracy, courts should be wary of usurping legislative authority in areas where the Parliamentary position is clear. …
Tony, 47, and Barrie Drewitt-Barlow, 42, of Chandlers Quay, Maldon, who were Britain's first gay surrogate parents, denied one charge of providing false information to an ethics panel. The pair, who ran Euroderm Research, also deny two counts of not conforming to protocol when conducting a trial. The pair appeared before Southwark Crown Court on Wednesday. They also deny two charges of conducting a clinical trial otherwise than in accordance of good clinical practice.
On the face of it, the decision by a High Court judge in the case of M is no surprise - few would have expected a ruling to allow a patient with any level of consciousness and feeling to die. But a closer inspection of the 76-page judgement shows that Mr Justice Baker did not find his decision a straightforward one.
When Penny Wark's brother died last year, her family did not hesitate to donate his organs. Despite the trauma, she thinks it was the right decision - but says grieving relatives must be treated with more care.
This paper examines the historical role of law and politics in the adoption of smallpox vaccination in Britain, focusing primarily on the early Victorian period, when legislation was passed to enforce compulsory infantile vaccination. The primary thesis of the study is that law, and the processes through which it is created and maintained, provide a distinct “envelope of social order” (Jasanoff 2008, 764) within which competing and duelling interests and opinions about scientific innovation find origin, expression, and debate. Consequently, the manner in which law responds to science and its impact on society is neither static nor self-evident, but subject to mutable circumstances that are historically, politically, and socially situated. The paper is divided into two main parts. The first provides a brief history of vaccination and the second focuses on events surrounding the introduction of compulsory vaccination laws in England and Wales.
Sir Terry Pratchett, the fantasy writer who was diagnosed with Alzheimer's in 2008, said yesterday he had started the formal process that could lead to his own assisted suicide at the Dignitas clinic in Switzerland. Pratchett, whose BBC2 film about the subject of assisted suicide is to be shown on BBC2 tomorrow, revealed he had been sent the consent forms requesting a suicide by the clinic and planned to sign them imminently. "The only thing stopping me [signing them] is that I have made this film and I have a bloody book to finish," he said during a question-and-answer session following a screening at the Sheffield documentary festival Doc/Fest. He said that he decided to start the process after making the film Terry Pratchett: Choosing to Die, which shows the moment of death of a motor neurone sufferer, millionaire hotel owner Peter Smedley.
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