Tag Archives: Assisted Dying

The withdrawal of food and fluid – the right to die – a new Supreme Court case

2 Aug

The withdrawal of food and fluid – the right to die


There was an important case this week in the Supreme Court, which is the highest Court in the UK regarding the withdrawal of food and fluid for some people.  This is changing the way that these matters are going to be dealt with in the future.


The first case of this kind was the sad case of Anthony Bland in 1993, he was a survivor of the Hillsborough disaster and was in a vegetative state, from which there was no chance of recovery, but as he was otherwise a fit young man at the time of the incident, he could have continued to live for years.  He had even undergone surgery without the need for anaesthetic, as he was brain dead and did not feel pain.  The case decided that it was in his interests to stop his food and fluid, so that ultimately, he would die, which is what happened.


Since then all other cases of minimally conscious patients go to the Court of Protection for a decision and each case is decided on its own merits.   Every case is expensive both in money terms, but also for the distress that the hearings cause to the loved ones, in part because of listening to the medical detail and in part with the anticipation and unknown nature of litigation.


So what did the Supreme Court decide?  In future all patients who are in either minimally conscious states or vegetative states can have food and fluid removed without the need to apply to the Court for an individual decision as long as both the family and the health authority agree that this is in the persons best interests.  If there is any disagreement, then this case is not relevant and also if the person is not clinically in one of the relevant coma like states.  If the criteria are fulfilled, then the person can be allowed to die following the withdrawal of food and fluid.  Their death will be managed to ensure that they are not in pain or suffering in any way.


There are estimates that at any one time in the UK there are about 3,000 people that this case might be relevant to.  The Court of Protection deals with around 1,500 new cases each year, with a legal cost of £50,000 to the health authority in each case, that £75m per year that the NHS can spend on something else, as well as end the distress to the families that the litigation causes.


There will still be cases that the Court has to decide on, those that do not fulfil the criteria of this case, in particular, when the family disagree.  This is not a case of assisted suicide, as without this artificial support these people would not survive, the only reason they are alive is the medical intervention that keeps that so, but there will be no doubt arguments that it is a case of assisted dying.  With no chance of recovery and no quality of life, I endorse the decision by the Court to make the situation easier for all involved, however heart wrenching that decision might be.



Assisted Dying and Disability

1 Feb


Assisted Dying and Disability


There is a new case going to the Court soon with a disabled person asking the Court to allow them to take their own life with the assistance of a medical professional, which is currently criminal in the UK.  http://www.bbc.co.uk/news/health-42733993


But should it be?


If I want to I can take my own life, it is not criminal.  What I cannot do is: aid, abet, counsel or procure mine or anyone else’s death.  So if I choose to take my own life, it has to be my settled decision and the act of doing so must be mine and only mine.


Is this discriminatory?


I can choose to take my life in a number of ways, but what if I wasn’t?  What if I had a physical health impairment that meant that I couldn’t do that?  It would mean that there is another part of society that I was unable to participate in.  The Equality Act 2010 says that where there is someone with a disability who needs access to something, then “reasonable adjustments” should be made to allow that person to do what they want / need.


The taking of a life is a huge, which most of society wishes wasn’t necessary, but in the depths of despair it can seem the only way out and is a difficult final action to take.  Many people have suicidal thoughts, not all of them act on it, it is part of depression.


The Mental Capacity Act has 5 principles and they are aimed at empowering the individual, including principle 3: No person is to be assumed to lack capacity because they make an unwise choice.  Because we all make what others would think is unwise choices from time to time!  So, the unwise choice to take one’s own life is not in itself sufficient to indicate that that person lacks mental capacity to make decisions, it might just be their physical impairment.


And who wants to be that person who assists?  That is a very difficult role to take on, since the entire subject is difficult and socially challenging to deal with!


Terry Pratchett took this argument to the Court a few years ago in 2011, the arguments will keep coming and the Courts will keep being faced with this issue.


I’m always sad when I hear that someone has taken their own life or wants to, my wish for them is that this desire and its underlying causes weren’t an issue in their life, but life isn’t always like that.  I wish all parties facing this issue the best.