Brain death is accepted in most countries as death. The rationales to explain why brain death is death are surprisingly problematic. The standard rationale that in brain death there has been loss of integrative unity of the organism has been shown to be false, and a better rationale has not been clearly articulated. Recent expert defences of the brain death concept are examined in this paper, and are suggested to be inadequate. I argue that, ironically, these defences demonstrate the lack of a defensible rationale for why brain death should be accepted as death itself. If brain death is death, a conceptual rationale for brain death being equivalent to death should be clarified, and this should be done urgently.
Sir Terry Pratchett has said he's ready to be a test case for assisted suicide "tribunals" which could give people legal permission to end their lives. The author, who has Alzheimer's, says he wants a tribunal set up to help those with incurable diseases end their lives with help from doctors. A poll for BBC One's Panorama suggests most people support assisted suicide for someone who is terminally ill.
A question has arisen as to whether it was in the public interest for the Crown Prosecution Service (CPS) to have prosecuted Kay Gilderdale for attempted murder. This is an important question and, in the interests of transparency and accountability, I have decided to issue a short public answer. As is well known, before proceeding with a case, the CPS must be satisfied that there is sufficient evidence to provide a realistic prospect of conviction and that it is in the public interest to bring the case before a court.
Should those with incurable illnesses be allowed to choose how and when they die? In his Richard Dimbleby lecture, author Terry Pratchett, who has Alzheimer's disease, makes a plea for a common-sense solution. This is an edited extract of Terry Pratchett's Richard Dimbleby lecture, Shaking Hands With Death, which was broadcast on BBC1 on 1 February
Following advance directives in emergencies throws up some complicated problems, as Stephen Bonner and colleagues found. We asked an emergency doctor, a medical defence adviser, and an ethicist what they would do in the circumstances
A mother has been found not guilty of the attempted murder of her severely ill daughter who had ME. Bridget Kathleen Gilderdale, 55, of Stonegate, East Sussex, was cleared of attempting to murder Lynn Gilderdale by jurors at Lewes Crown Court. Gilderdale had previously admitted aiding and abetting the suicide of her 31-year-old daughter and was given a 12-month conditional discharge.
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.
Switzerland's laws that prohibit killing continue to apply in full. Direct, active euthanasia (deliberate killing in order to end the suffering of another person) is therefore also forbidden. By contrast, both indirect, active euthanasia (the use of means having side-effects that may shorten life) and passive euthanasia (rejecting or discontinuing life-prolonging measures) – while not governed by any specific statutory provisions – are not treated as criminal offences provided certain conditions are fulfilled. No legislative action is needed with regard to these three forms of euthanasia. Legal restrictions and a ban on organised assisted suicide are nonetheless open to debate. They are intended to protect human life better, and to prevent organised assisted suicide becoming a profit-driven business.
The Swiss government is considering restricting or even banning organised assisted suicide in an attempt to reduce so-called "death tourism". Swiss authorities want to ensure euthanasia is a last resort for the terminally ill, amid fears their current laws on assisted suicide could be open to abuse. A study last year suggested more and more people seeking help to die in Switzerland did not have a terminal illness. "We have no interest, as a country, in being attractive for suicide tourism," the Swiss justice minister, Eveline Widmer-Schlumpf, told reporters in Berne, adding that more foreigners were travelling to Switzerland to die.
This woman was diagnosed with cancer and says she should be allowed to end her life when the time is right. A survey we carried out shows most people share her views.
This short paper for one of the world's leading bioethics journals introduces readers to medical tourism - the travel of patients from their home country to another for the primary purpose of seeking medical treatment. The paper divides medical tourism into three types: (1) Medical tourism for services illegal in both the patient's home and destination countries (e.g., organ transplant tourism); (2) Medical tourism for services that are illegal in the patient's home country but legal in the destination country (e.g., some forms of fertility tourism, euthanasia tourism, experimental drug tourism); (3) Medical tourism for services legal in both the home and destination country (e.g., traveling abroad for a heart valve or hip replacement). The paper then discusses several difficult ethical and regulatory challenges posed by each type of medical tourism.
The Karnataka high court on Tuesday directed the state government to furnish medical records of HB Karibasamma, a 70-year-old woman seeking the court’s permission for euthanasia. Justice Ajit Gunjal while hearing the petition asked the government to provide the records in a week’s time. Gunjal also issued notices to the ministry of parliamentary affairs, ministry of law and justice, and the chief secretary, Karnataka. This is the first case in the Karnataka high court seeking permission for mercy killing. Pramila Nesargi, senior counsel and former chairperson of the State Women’s Commission, representing Karibasamma, said the petitioner could be granted the right to die with dignity as she did not want to be a burden on the society.
More than eight out of 10 Quebecers support the legalization of euthanasia, according to a survey commissioned by CBC and Radio-Canada. At least 83 per cent of Quebecers polled earlier this month agree that euthanasia and physician-assisted suicide should be allowed in certain cases. The poll, conducted between Nov. 5 and 15, and based on 2,200 telephone interviews, also found a minority of respondents would choose euthanasia for themselves or a loved one.
BBC television presenter Ray Gosling will be charged with wasting police time, following a claim he made on air that he smothered his terminally ill lover. The Crown Prosecution Service said Mr Gosling should be charged over claims he made to BBC Breakfast's Bill Turnbull in February, after first making the claim in a BBC Inside Out documentary broadcast on 15 February. Mr Gosling said he was sorry if there had been any hurt caused to his former lover - who had been dying of Aids - or his family.
Two people have been arrested on suspicion of assisting the suicide of a disabled man from South Tyneside. Retired engineer Douglas Sinclair, 76, had been suffering from the debilitating disorder multiple system atrophy, his solicitor said. Christopher Potts said Mr Sinclair died in Zurich on 28 July. He arranged his death through the Swiss assisted-suicide organisation Dignitas. The woman and man who were arrested have been bailed as inquiries continue. Mr Sinclair, a father-of-one, had had the condition for two years. He was being cared for at a care home in Jarrow, South Tyneside, when his conditioned worsened earlier this year.
So the court of appeal has decided: Frances Inglis, the woman convicted of killing her brain-damaged son Thomas in January this year by injecting him with heroin, is a murderer.
One of the Australian Greens' first parliamentary priorities will be to try to overturn laws which stop the territories from legislating around euthanasia.
The BMA has long advised doctors - for moral as well as legal reasons - to avoid actions that might be interpreted as assisting, facilitating or encouraging a suicide attempt. This means not giving patients advice on what constitutes a fatal dose or on anti-emetics in relation to a planned overdose, not suggesting the option of suicide abroad nor writing medical reports specifically to facilitate assisted dying abroad, nor on any other aspects of planning a suicide.
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.
Assisted dying should form part of a good palliative care service for terminally ill people in the United Kingdom, said Ann McPherson, a GP and founder of a new group of medical professionals called Dignity in Dying: Healthcare Professionals for Change (BMJ 2010;341:c5498, doi:10.1136/bmj.c5498). Speaking at a debate hosted by the Medical Journalists’ Association last week on assisted dying and whether the law should be changed, Dr McPherson, who is herself dying from pancreatic cancer, called for the law on assisted dying to be changed in a “narrow way” so that people who are dying and who are able to make the decision on how and when they would like to end their life can do so. “Without a change in the law it will make it much more difficult for some people to have a dignified death, which is what everybody is entitled to,” she said.
UK doctors have set up a new group for health professionals to challenge the BMA and a number of royal colleges in their stance against assisted dying for terminally ill people and to push for a change in the law. The group, called Dignity in Dying: Healthcare Professionals for Change, was set up by Ann McPherson, who is dying of pancreatic cancer, after an article she wrote in the BMJ last year generated interest in giving people who are dying the option of help to end their lives when they chose (BMJ 2009;339:b2827 doi:10.1136/bmj.b2827). Dr McPherson, who is a fellow of the Royal College of General Practitioners, said she wants the royal colleges to have a more informed debate about assisted suicide.
L’acquittement de l’ancienne médecin cantonale en retenant l’état de nécessité constitue une première en Suisse. Le Ministère public devrait déposer un recours au TF avant la refonte de la législation prévue pour 2011
Britain To Clarify Policy on Euthanasia - Prosecution Factors Will Be Spelled Out By Karla Adam Special to The Washington Post Wednesday, September 23, 2009
Legal guidelines aimed at clarifying the law on assisted suicide will not be prepared in Scotland. The director of public prosecutions in England and Wales has spelled out a range of factors to be taken into account when deciding on cases. However, Scotland's top law officer, Lord Advocate Elish Angiolini, said it would be inappropriate for her to publish detailed guidance. Ms Angiolini said the legal landscape in Scotland was different. In response to a letter from Liberal Democrat MSP Jeremy Purvis, Ms Angiolini said the statutory offence of assisted suicide did not exist in Scotland. However, she said involvement in a suicide might amount to homicide and that was up to Scotland's "different system" of public prosecution to determine.
VANCOUVER, B.C. — An Australian right-to-die group that wants to teach seriously ill patients how to end their lives has been turned away by the Vancouver public library over concerns that such an event could violate laws that prohibit assisted suicide. Melbourne-based Exit International wants to hold a workshop in November that would include information about which drugs patients can take to kill themselves, how to obtain them and how to take them. The Vancouver Public Library initially took the booking, but has since cancelled after receiving legal advice from its lawyers and local police, said central librarian Paul Whitney. "The library was told in what, for lawyers, I would describe as fairly unambiguous language that the program as presented by Exit International would be in contravention of the Criminal Code," Whitney said Monday. Federal law makes it a crime to counsel, aid or abet someone to kill themselves.
Campaigners hailed the guidelines as a victory for common sense. But “right to life” groups said that he had exceeded his authority. Groups from the Law Society to Dignity in Dying insisted that Parliament should still legislate. Mr Starmer said the list of factors weighing in favour or against a prosecution did not mean that assisted suicide was no longer a criminal offence. Lord Falconer of Thoroton, a former Lord Chancellor and the first Justice Secretary, who tried recently to reform the law, hailed the DPP’s guidelines as a “very, very significant step” and said he had “unquestionably changed the law”. “He has done what the law lords ordered him to do — give certainty to people as to what will happen if they decide to help their loved ones to die.”
Proponents of assisted suicide believe support for legalisation is growing among lawmakers and the public around the world. In the past year three names have been added to the list of places which permit it. The BBC's Vincent Dowd investigates whether assisted suicide is set to become even more common.
Guernsey's former health and social services minister says he wants the debate on assisted suicide to be reopened in the island. His comments followed a review into the current UK law aimed at making it clear when someone would be prosecuted. Peter Roffey said public opinion had changed considerably in the five years since he took a report to the States. He said he believed assisting a suicide for compassionate reasons would have the support of the law within 10 years. Mr Roffey said: "What I'd really like to see is a change in the law in England, an honest approach to it, not just saying 'you're still committing a serious crime but we won't prosecute you'. "But if they're not going to prosecute in those circumstances where the action has been driven by compassion there ought to actually be some legislative changes."
A government source said: "Parliament is currently divided on this issue, but it may be that after Starmer produces his guidance, politicians will recognise that this is an ethical issue that cannot be left" to the Crown Prosecution Service alone.
The director of public prosecutions (DPP) must spell out clearly his policy on prosecuting people in England and Wales who help friends or relatives go abroad for assisted suicide, the UK’s highest court has ruled. The unanimous judgment from five law lords is a victory for Debbie Purdy, who has primary progressive multiple sclerosis and wants her husband to help her travel to Switzerland—where assisted suicide is lawful—when she decides to die.
Campaigner Debbie Purdy has called for an "open debate" on assisted suicide laws after her landmark court victory. Prosecutors are to clarify the law after Law Lords backed Ms Purdy's call for formal advice on the legal position of those who help a loved one to die.
End of life decisions that shorten life, including euthanasia or physician assisted suicide, are not related to a lower use of palliative care in Belgium and often occur within the context of multidisciplinary care.
Proponents for the legalization of physician assisted suicide (PAS ) argue that it has been legal in Oregon since 1997 and that it works well. They maintain that palliative and hospice care can co-exist comfortably with the option for PAS. My aim was to examine these claims, in two cities in the Northwest of America; Seattle where there is no legalized PAS and Portland where PAS is legal.
At least 200 terminally-ill people from Australia, Britain, New Zealand and the United States have visited Mexico since 2001 to buy a euthanasia drug, a newspaper has reported. The Mexican newspaper Reforma cited Exit International - the mercy killing organisation run by Australian euthanasia advocate Phillip Nitschke that promotes Mexico as a destination for patients seeking to end their lives. "On the basis of Exit research, the best places to visit are the 20-odd (United States-Mexico) border crossings, from Tijuana in California through to Matamoros on the Gulf of Mexico," the group says on its website.
Exit International is the world's leading Voluntary Euthanasia & Assisted Suicide information and advocacy organisation. A registered non-profit organisation, Exit was founded in 1997 by Philip Nitschke. In 1996, Dr Nitschke became the first physician to administer a legal, lethal voluntary injection, under the world's first right to die law - the Rights of the Terminally Ill Act of the Northern Territory of Australia.
Background: In Switzerland, non-medical right-to-die organisations such as Exit Deutsche Schweiz and Dignitas offer suicide assistance to members suffering from incurable diseases. Objectives: First, to determine whether differences exist between the members who received assistance in suicide from Exit Deutsche Schweiz and Dignitas. Second, to investigate whether the practices of Exit Deutsche Schweiz have changed since the 1990s. Conclusions: Weariness of life rather than a fatal or hopeless medical condition may be a more common reason for older members of Exit Deutsche Schweiz to commit suicide. The strong over-representation of women in both Exit Deutsche Schweiz and Dignitas suicides is an important phenomenon so far largely overlooked and in need of further study.
Ganzini and colleagues’ finding that 3 of the 18 Oregonians who received a prescription for a lethal drug met caseness criteria for depression raises concerns about the state’s Death with Dignity Act, which demands a psychiatric review only if "concern exists that the patient has a psychiatric disorder." We know that depression is common in the terminally ill and that depression may be successfully treated in this population. We know that depression may impair a person’s capacity when requesting physician assisted suicide, and we know that non-psychiatrically trained physicians are poor at detecting depression. We also know that these four facts are true for delirium in patients who are terminally ill. There is a strong argument for including mandatory psychiatric review in any legislation that enables physician assisted death, to detect and protect those who would not have requested assistance to die had they not been depressed or delirious.