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Case Histories: end of life decisions
Diane Pretty's is not the first name to reach the headlines on the subject of euthanasia.
Though each case is different, there have been several precendents in the UK. This article summarises six of the main cases.
Case 1: Tony Bland, 1989
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.
After the Hillsborough stadium tragedy, Tony was left in a persistent vegetative state - and hence was not legally dead.
His parents believed their son would not want to be kept alive in such a condition.
They petitioned the court to sanction the withdrawal of hydration and artificial nutrition, which it did.
Case 2: Dr Nigel Cox, 1992
Dr Nigel Cox remains the only doctor ever to be convicted in the UK of attempting to perform a mercy killing.
A consultant rheumatologist from Hampshire, he was found guilty of attempted murder after injecting 70-year-old Lillian Boyes with a lethal drug.
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.
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.
Case 3: Mary Ormerod, 1995
Mary Ormerod was starved of food and fluids.
Her doctor, with the support of her daughters, had taken a conscious decision to withhold a nutritional supplement called Fresubin from the 85-year-old after she ceased to communicate with the outside world.
But Dr Ken Taylor, the GP who took the decision, was suspended by the General Medical Council, the regulatory body for doctors, after nurses at the home complained about his actions.
His six-month suspension was not directly because of his treatment of Mrs Ormerod, but because he failed to listen to nurses and consult colleagues.
In fact, he had done nothing legally wrong in starving Mrs Ormerod.
This is because, under the ruling of Tony Bland's case, artificial nutrition and hydration is regarded as medical treatment.
Case 4: Annie Lindsell, 1997
Annie Lindsell died of motor neurone disease in December 1997.
Her greatest fear was the prospect of suffocating or choking to death when breathing and swallowing became difficult.
With only weeks to live, she asked the High Court to rule that if this happened, her doctor could intervene and administer diamorphine - without fear of prosecution - even if it might shorten her life.
She withdrew the case in October 1997 after she established the principle that doctors could legally administer life-shortening drugs for the relief of mental as well as physical distress.
She was assured that her doctor would not allow her to suffer unneccesarily and a treatment plan was agreed which followed best medical practice.
She died without recourse to the treatment plan. She had only been diagnosed in 1992.
Case 5: Dr Moor, 1998
Dr Moor was charged with the murder of George Liddell, an 85-year-old terminally ill cancer patient.
However, while he admitted giving Mr Liddell a dose of diamorphine, Dr Moor said he had only done so to relieve pain, not to kill him.
What made the case unusual was that not only did Dr Moor admit in the media to administering a lethal dose of drugs to many patients, he also admitted that he had done so within days of giving the interview.
After his acquittal in May 1999, he said he would do it all over again.
The verdict established once and for all that doctors who administer drugs to relieve pain are acting within the law, whether or not the patient dies as a result.
Case 6: Miss B, 2002
A woman known as "Miss B", who was paralysed from the neck down, died peacefully in her sleep on 29 April 2002 after winning the legal right to have medical treatment withdrawn.
Dame Elizabeth Butler-Sloss, President of the High Court family division, ruled last month that Miss B had the "necessary mental capacity to give consent or to refuse consent to life-sustaining medical treatment".
It was the 43-year-old former social care professional's case that it was her decision, not her doctors', whether the ventilator which kept her alive should be switched off.
In a landmark ruling, Dame Elizabeth gave Miss B the right to be transferred to another hospital and be treated in accordance with her wishes, including drug treatment and care to "ease her suffering and permit her life to end peacefully and with dignity".
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