'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.
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.
The husband of a woman who died in one of Britain's best-known hospitals is taking its management and the health secretary Andrew Lansley to court, alleging an illegal use of "do not resuscitate" orders. David Tracey claims doctors at Addenbrooke's hospital, Cambridge, twice put such orders in his wife's medical notes, cancelling the first after she objected to it only to put in a second three days later without her consent or any discussion with her. Tracey alleges the hospital's actions deprived his 63-year-old wife Janet of the right to life and subjected her to degrading treatment, while he was denied respect for his personal and family life. He is also seeking to force the coalition government to draw up a policy for England on the use of Do Not Attempt Cardio-pulmonary Resuscitation (DNACPR) instructions, and claims the present system of local policies is open to abuse.
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.
This is an application made by the NHS Foundation Trust in the Court of Protection for a raft of declarations in relation to a young man, M, who was born on 19th June 1990 and so approaches his 23rd birthday. M was tragically born with a congenital abnormality of the brain called holoprosencephaly ("HPE"). It is common ground that in the period of time since 2010 M's condition has significantly deteriorated. He is now seriously malnourished and, in the view of both the treating physicians and independent experts instructed for the purposes of this hearing, reaching the end of his life. The painful and difficult issues now to be faced by M's family, the medical team that have cared for him so diligently over many years, and ultimately this court, is to what extent should M be treated in Intensive Care or be given cardio-pulmonary resuscitation ("CPR") in the event that there is a further deterioration in his condition. There is no question of M having the capacity himself to make...
Although DJ's condition is in many respects grim, I am not persuaded that treatment would be futile or overly burdensome, or that there is no prospect of recovery. (a) In DJ's case, the treatments in question cannot be said to be futile, based upon the evidence of their effect so far. (b) Nor can they be said to be futile in the sense that they could only return DJ to a quality of life that is not worth living. (c) Although the burdens of treatment are very great indeed, they have to be weighed against the benefits of a continued existence. (d) Nor can it be said that there is no prospect of recovery: recovery does not mean a return to full health, but the resumption of a quality of life that DJ would regard as worthwhile. The references, noted above, to a cure or a return to the former pleasures of life set the standard unduly high.
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
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 order by Mr Justice Baker was issued in a case involving a woman, who can be referred to only as "M". She has been in "a minimally conscious state" since suffering from swelling of the brain stem, which caused serious damage and wasting to the brain. The woman suffered the illness in 2003, when she was 43, and has been minimally conscious since then.
A hospital trust can withhold life-saving treatment from a severely brain-damaged Muslim man if his condition deteriorates, a court has ruled. Doctors argued it would be unfair to resuscitate the patient, known as Mr L, if his condition worsened. His family, of Greater Manchester, said that was against their Muslim faith. At the Court of Protection, Mr Justice Moylan said it would be lawful to withhold treatment as it would not prolong life "in any meaningful way". He added: "It would result in death being characterised by a series of harmful interventions without any realistic prospect of such treatment producing any benefit."
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.
A mother is seeking a court's permission to withdraw life-sustaining artificial nutrition and hydration from her brain-damaged daughter. The woman, 53, who can only be referred to as "M" for legal reasons, is in a "minimally conscious state".
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."