Physician assisted suicide has been legal for a decade in the US state of Oregon. But palliative care specialist David Jeffrey says there are grave questions about whether people are being helped to die, when treatment for depression could be a highly successful alternative. In this week's Scrubbing Up column Dr Jeffrey, who is based at the University of Edinburgh, says a patient should be free to end their life - but doctors should not be involved.
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.
Introduction: In The Netherlands, physicians have to be convinced that the patient suffers unbearably and hopelessly before granting a request for euthanasia. The extent to which general practitioners (GPs), consulted physicians and members of the euthanasia review committees judge this criterion similarly was evaluated.
More than 700,000 people in the UK currently suffer from dementia, and nearly 500,000 friends and family members act as carers for people with dementia. Our rapidly ageing population means that these numbers are likely to double in the next forty years. While we are getting to understand better the causes of the disease, and diagnostic and treatment options are improving, we are still a long way from prevention or cure. Meanwhile, these people and their families, healthcare staff and care workers face difficult ethical dilemmas on a day-to-day basis. An exploratory workshop was held in March 2007, and the Nuffield Council set up a Working Party in December 2007 to examine the ethical issues raised by dementia. Following a public consultation and meetings with stakeholders including people with dementia, carers, health professionals and other members of the public, a report with recommendations for policy makers was published on 1st October 2009.
Ms. Francine Lalonde moved that Bill C-384, An Act to amend the Criminal Code (right to die with dignity) be read the second time and referred to a committee: Mr. Speaker, I first introduced a private member's bill on the right to die with dignity in June 2005 . . . In fact, I introduced this bill so that people would have a choice, the same right to choose that people in other countries have. My conviction has grown stronger, and that is why I am introducing an amended bill on the right to die with dignity, Bill C-384. Briefly, it amends the Criminal code so that a medical practitioner does not commit homicide just by helping a person to die with dignity if the person continues to experience severe physical or mental pain without any prospect of relief or suffers from a terminal illness.
A father is fighting a hospital's attempt to withdraw support keeping his baby son alive. The one-year-old, known as Baby RB for legal reasons, was born with a rare, genetic muscle condition that makes it hard for him to breathe independently. His parents are going to the High Court - the mother is reportedly supporting the hospital's bid. The father's lawyers argue that the boy's brain is unaffected, meaning he can see, hear, interact and play. Despite having to remain in hospital and being dependent on a ventilator to breathe, he enjoys having stories read to him and listening to music, they say. The lawyers are submitting video footage to the court, which they say shows him playing with his toys. But the hospital says that Baby RB's quality of life is so low that it would not be in his best interests to try to save him. Baby RB was born with congenital myasthenic syndrome and has been in hospital since birth.
A father whose son was born with a rare neuromuscular condition will go to the high court tomorrow in an attempt to stop a hospital withdrawing the support that keeps the child alive. Doctors treating the one-year-old say the boy's quality of life is so poor that it would not be in his best interests to save him. They are reportedly being supported in their action by the baby's mother, who is separated from his father. The child, known for legal reasons as Baby RB, was born with congenital myasthenic syndrome (CMS), a muscle condition that severely limits movement and the ability to breathe independently. He has been in hospital since birth. If the hospital succeeds in its application, it will be the first time a British court has gone against the wishes of a parent and ruled that life support can be discontinued or withdrawn from a child who does not have brain damage.
A one-year-old boy at the centre of a "right-to-life" legal dispute would not benefit from an operation to help him breathe, the High Court has been told. The child, known as Baby RB, has a rare, genetic condition that makes it hard for him to breathe independently. But a leading paediatrician, known as Dr F, said he was "not a candidate" for surgery to try to open up his airway. Baby RB's father is fighting a hospital's attempt - backed by the mother - to withdraw his life support.
A doctor has agreed a baby in a "right-to-life" legal row may be able to interact - but any mental development would only make his fate more tragic. The paediatric neurologist told the High Court the severely disabled child, Baby RB, would remain in a "no chance" situation even if he developed further. He questioned the life the boy would lead if he was capable of cognitive function but physically so disabled.
A doctor has said that a baby in a "right-to-life" legal row has the potential to communicate and even operate a wheelchair in years to come. The paediatric neurologist, Professor Fenella Kirkham, told the High Court that Baby RB had the normal intelligence of a one-year-old. She said he was likely to develop language recognition skills and he may be better off at home. The boy's father is fighting an attempt by the hospital to end life support.
A father who had been fighting to stop a hospital withdrawing life support from his seriously ill son has dropped his objections. The one-year-old, known as Baby RB for legal reasons, was born with a rare, genetic muscle condition that makes it hard for him to breathe independently. The hospital was backed by the baby's mother. But the move had been strongly opposed by the child's father at a High Court hearing. However, the father changed his mind after hearing medical evidence which suggested it would be in the best interests of the child if medical support was withdrawn. Lawyers for the health authority caring for the baby in intensive care told Mr Justice McFarlane: "All of the parties in court now agree that it would be in RB's best interests for the course suggested by the doctors to be followed."
A father who went to the High Court to try to stop a hospital turning off his seriously ill baby son's life support machine has dropped his objections to the move. The outcome has prompted a mixture of sadness and relief. For six days they had sat in the bland surroundings of Court 50 at London's High Court listening to others talking about their baby son's quality of life. A host of paediatricians, nurses, and experts went into the witness box. Many of them urged a judge to decide that this profoundly disabled 13-month-old boy should be allowed to die. It was, they said, no longer in his best interests to keep him alive.
Not all patients who requested euthanasia thought their suffering was unbearable, although they had a lasting wish to die. Patients and physicians seemed to agree about this. In cases in which patients said they suffered unbearably there was less agreement about what constitutes unbearable suffering; patients put more emphasis on psychosocial suffering, such as dependence and deterioration, whereas physicians referred more often to physical suffering. In some cases the physician thought that the suffering was not unbearable because the patient’s behaviour seemed incompatible with unbearable suffering—for instance, because the patient was still reading books.
The number of people suffering from dementia will rise considerably in the years to come. This will have important implications for society. People suffering from dementia have to rely on relatives and professional caregivers when their disorder progresses. Some people want to determine for themselves their moment of death, if they should become demented. They think that the decline in personality caused by severe dementia is shocking and unacceptable. In this context, some people consider euthanasia as a way to avoid total deterioration. In this article, we discuss some practical and ethical dilemmas regarding euthanasia in persons with severe dementia based on an advance euthanasia directive.
Raphael Cohen-Almagor, University of Hull FROM NEW MEDICAL ETHICS TO INTEGRATIVE BIOETHICS, Ante Covic, Nada Gosic, Luka Tomasevic, eds., pp. 197-216, Zagreb, Pergamena, 2009
In February 2010 the NVVE, Right-to-Die Netherlands, supported by other social organizations, started the campaign Completed Life. Interrupting this societal debate again shouldn’t be allowed. The NVVE is of the opinion that the elderly should be allowed to make a well thought-through choice at the end of their lives and that such a choice will be entirely up to them. Of course, people are not forced to make use of assisted suicide, but they should be at liberty to resort to such, if they wish to. When human suffering can be avoided, the NVVE is of the opinion that access to assistance shouldn’t be withheld. Obviously, under all circumstances all forms of due-care should be practiced.
Following the House of Lords' decision in Purdy, the Director of Public Prosecutions issued an interim policy for prosecutors setting out the factors to be considered when deciding whether a prosecution in an assisted suicide case is in the public interest. This paper considers the interim policy, the subsequent public consultation and the resulting final policy. Key aspects of the policy are examined, including the condition of the victim, the decision to commit suicide and the role of organised or professional assistance. The inclusion of assisted suicides which take place within England and Wales makes the informal legal change realised by the policy more significant than was originally anticipated.