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Euthanasia Wednesday, 12 May, 1999, 16:13 GMT 17:13 UK
Euthanasia: An overview
In the wake of the Dr Moor trial, BBC Health Correspondent Richard Hannaford offers a round-up of the central issues in the euthanasia debate.

Back in 1992 I was called on to cover the case of Dr Nigel Cox, a consultant rheumatologist from Hampshire. He was found guilty of attempted murder, after injecting a 70-year-old patient with a lethal drug.

Health: Background Briefing: Euthanasia
Lillian Boyes was said to be terminally ill. She was in extreme pain and regularly begged for her life to be ended.

Dr Cox's act was discovered by a nurse who read Miss Boyes medical notes. She realised that the potassium chloride he had used would not alleviate pain, but instead stop Ms Boyes' heart.

The charge of attempted murder was brought because it could not be proved conclusively that the injection had killed her.

Despite the verdict, Winchester Crown Court imposed a suspended sentence, while the General Medical Council let him off with a reprimand. He is still practising medicine in Hampshire.

He remains the only doctor ever to be convicted in the UK of attempting to perform a mercy killing.

Complex issue

But the subject of voluntary euthanasia is far from simple - even the most sympathetic cases raise difficult ethical questions.

Pro-euthanasia campaigners say it is a matter of personal freedom.

As suicide is no longer a crime in the UK, they argue that it is not only just, but also an essential part of civilisation that people can be helped to die in dignity and painfree.

They argue that refusing to help someone is immoral. It could even cause more injury and distress, if the suicide attempt is botched.

Opposing that view is a coalition of opinion.

Some religious groups believe life is sacrosanct and only God can decide when to terminate it.

Other groups worry that allowing any system of legalised killing would be open to abuse.

Recent research from Holland suggests that despite that country's strict rules concerning voluntary euthanasia, many doctors are failing to carry out the necessary checks or contact the appropriate authorities.

Case studies

And then of course there are the relatives.

When faced with their loved ones' pain, and often the indignity of their condition, many are desperate and believe the best course is for their relative to die.

During Dr Cox's court case and subsequent appearance before the General Medical Council, Ms Boyes' family never wavered in their support for the doctor's actions.

When doctors at Airedale Hospital in Yorkshire asked the High Court for permission to withdraw artificial nutrition and hydration from Hillsborough victim Tony Bland, his family supported the application.

And recently the family of Mary Ormerod, who died after being starved of food and fluids, praised the doctor involved as being caring and committed.

Although euthanasia is illegal in the UK, there are some grey areas. A doctor can legally give a person an overdose of an opiate like morphine - even if they know it will kill the patient.

As long as the intention is to ease suffering, they cannot be prosecuted for murder. Known as the principle of "double effect", many doctors admit that they have done this - even that their motives were mixed.

But critics say some GPs resort to this before exhausting all other options.

Pain relief

Many experts in pain relief say that doctors too often do not know enough about caring for terminally-ill patients and the latest advances in pain control.

It has also been common practice in hospitals for doctors to write "Do Not Resuscitate" or DNR on the notes of some frail patients.

In those circumstances, nurses and doctors will not attempt to revive a person who has - for example - a heart attack, because keeping them alive would, in the opinion of the medics, inflict more suffering.

Opinion polls suggest the general public is more sympathetic towards those who attempt to kill themselves - even that there is support for changes in the law to decriminalise the act of helping someone commit suicide.

However, it is very unlikely that any political party will support any changes in the law in the near future.

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