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Tuesday, 12 March, 2002, 10:15 GMT
The right to die: Who decides?
The High Court has been asked to decide whether a fully conscious woman being kept alive on a ventilator can be allowed to die.
The woman, who cannot be identified, has been paralysed since rupturing a blood vessel in her spine a year ago.
Her condition is stable, but her chances of improvement are put at under 1%.
Her lawyer, Richard Stein, says she has been wanting to terminate her treatment "ever since she has known the prognosis is so poor."
But doctors say she cannot make a truly informed decision before she has tried a rehabilitation centre, where she would be given special aids to try to improve the quality of her life.
Who should have the right to decide whether you live or die?
This debate is now closed. Read a selection of your comments below.
Surely what the doctors are doing is illegal at present, giving her treatment against her repeatedly expressed will. Just because she is physically unable to resist this does not warrant her verbal requests being ignored. Having said that, she doesn't appear to want to die badly enough to switch her own machine off by remote control.
As a practising intensive care doctor I feel that this woman has a perfect right to refuse a treatment that she feels is not in her best interests. I and my colleagues have complied with the wishes of patients in very similar positions and I for one would do so again.
I hate to think of the cost of keeping this woman alive against her will, to say nothing of that of the court case. Last week a little girl was denied a bone marrow transplant needed to save her life because of the cost! Only the fuss in the press made the operation go ahead. Where are our priorities?
M Hay, UK
Can you imagine how frustrating it must be when, completely paralysed and unable to do anything, the one thing that you want is denied to you? How very arrogant of the doctors and nurses at that hospital to think that their specialist knowledge and skills are demanded by everybody. The NHS is a Service, so why does it not serve this woman in the way that she asks? She does, after all, pay for it.
Reading the comments in this talking point has been very inspiring. Each response has made me think. I'm someone who believes in miracles but other than that, I believe that quality of life can always be improved. The rehabilitation is very wise advice which should really be considered. However, this would be different if this woman suffers a great pain which she cannot bear. It would be inhuman to let her suffer when she does not have to. Her decision to end her life by stopping treatment seems very wrong to me. But at the end, it's not about mine or your opinion, it's hers.
"I will prescribe regimen for the good of my patients according to my ability and my judgment and never do harm to anyone" - The Hippocratic Oath. I think the doctors and lawyers involved in this case need to get their heads round this one - and fast! If the doctors' only objective is to prolong life irrespective of quality or suffering (mental or physical) then they need relieving of their responsibilities forthwith - a doctor's responsibility is to relieve suffering - he/she cannot always preserve life in a liveable form. The lawyers need to understand this and the law needs to act accordingly.
I see the patient has declined to switch herself off with a remote because she wouldn't want her god-daughter to think she committed suicide. Maybe the doctors don't want their children thinking they have committed murder?
Gareth L, UK
I was under the impression that by law any person has the right to refuse treatment.
Claiming that she cannot make an 'informed decision' is worrying. I'm not a doctor, does this mean I'm not informed enough to refuse antibiotics or cough medicine? I know the woman's life is at stake, but its her choice. Take away that choice and we take away one of the most important human rights of all.
To all the religious people out there - God didn't decide to put her on a ventilator with absolutely no hope of ever getting better!
Quantity of Life is not always preferable to Quality of Life.
That this question is asked suggests a grossly distorted moral view. Of course we have the right to choose our own deaths, as we have the right to eat what we want, to breathe when we want, and not to breathe if we don't want. What sick mind could suggest otherwise? I can only assume that religious people might have a problem with this and they would be ignoring the fact that, in this particular case, it's the choice to refuse treatment which she is taking. That refusal will kill her or, to put it better, will allow her to die.
I will have to face the possibility soon that my own father will wish to die if my mother dies first.
I know his wishes, he has stated them repeatedly over the years, through robust health to stroke-induced disability.
The thought of condemning anyone to a "life" that they do not want fills me with profound revulsion and pity. I wish that those opposed to this through ignorance and religious dogma think long and hard on the suffering that this woman will endure for many, many years.
C. Packwood, Suffolk, England
It was inspiring to read on this site a few days ago about the wheelchair bound former Superman actor influencing the House of Lords to decide in favour of limited stem cell research because it kept his hope alive of walking again. History is replete with those who rose from the depths of suicidal despondency to make a meaningful existence of their lives. Biopics like The Awakening, A Beautiful Mind and the life of people like Stephen Hawkins all attest to what is possible when hope and faith are introduced into an otherwise impossible situation. As to the original question of who decides? God.
If doctors are permitted to emblazon certain (mainly elderly) patients' notes with the instruction DO NOT RECUSITATE, then surely a patient of sound mind but unfit body should have a greater right to choose to end their painful or undignified life?
What a sad world we live in. This woman has a legal right to refuse medical treatment; the doctors concerned should be ashamed of themselves.
I am expected to be responsible for my life. And why not my death? Euthanasia should not be easy and it should be not be impossible.
All our lives are entwined, the decisions taken by one individual can affect the way in which other lives are perceived, we cannot take any risks with death. Although these circumstances are upsetting, the law should not be changed to sanction the elimination of any individual.
Stephen Bailie, N Ireland
As a nurse, I believe that people like this woman have the right to decide once all paths have been explored. What right have we to say, "Her head works so she should live"? No - put those that do in a ward full of fully dependent people and then perhaps they would understand about dignity, which is a word that was drummed into us as student nurses in the UK.
Judy Excell, England, UK
There is a difference between being allowed to die with dignity and being deliberately killed. The doctors have a case that she hasn't yet tried all the rehabilitation options yet. If she tries those and still feels that taking such extreme measures to keep her alive are against her human dignity then yes, let her die in peace.
Yes - one must have the right to choose death over life in these circumstances. Existence under these conditions would be for most people mentally agonising. Death is a natural outcome to her horribly unfortunate condition. She is being forced to accept the law of the land, and denied the law of nature. I would also like to make the valuable point that under these circumstances and those similar, life assurance policies should be honoured.
Allowing people to decide their own destiny is a fundamental freedom and allows resources to be directed to areas that improve the quality of life. Too often patients' needs are secondary to the challenge presented to medics.
God giveth and God taketh away.
Olga M, London, UK
Surely she has the same rights as everybody else, including the right to discharge herself from hospital? In this case, where no assistance is required, the right to refuse treatment amounts to the right to end her life.
Chris Harrison, UK
How is it that a relative deciding to switch off a life support machine is fine when you can't decide yourself? I thought suicide was decriminalised yet here we are with someone just wishing that treatment be ceased. Did she sign the treatment consent form?
If she is conscious, then turning off the ventilator would be helping someone commit suicide.
Those who go on about religious reasons and suicide being a sin are the ones guilty of the greater evil if they insist on keeping someone in an unbearable existence against their wishes. They aren't the ones being buried alive. Being trapped inside a body, unable to do anything and perfectly concsious is my idea of hell. I can't imagine how anyone could deny this woman the right to end her own life.
Each individual makes decisions every day that affect the length of their life. The decision should therefore be yours.
Why not compromise and send her to a rehabilitation centre for six months? If afterwards, she still wants to die then allow her to.
Chris Jones, UK
It's bizarre that this case is going anywhere near a court. This woman is fully compos-mentis, and has decided she does not wish to be treated. Surely giving her medical treatment against her will constitutes assault? If I were in her condition, I'd want the same.
For most people and since the farthest antiquity, life in whatever condition is sacred and the right to live inviolable. Even if it comes down to a question of rights, the doctor has a right not to be forced into an act he disagrees with, especially since he or she has given the Hippocratic oath.
But who's going to pull the plug?
No healthy person should suppose they can get anywhere near to imagining what this unfortunate woman is going through. So we mustn't be too judgmental on her.
Secondly, however cost- and time-saving it would be, it is impossible to make a "one fits all" decision on cases like this. Each case should be investigated and decided on its own merits - I doubt if there could ever be two entirely identical cases. The medical condition might be nearly identical but the patient's psychological state and social/family circumstances will differ, so we can't avoid the cost and effort of making individual decisions - it is about lives, after all. My heart goes out to this unfortunate woman.
If the person concerned shouldn't have the right to decide when and in what manner their life ends, then who should? Obviously people are uneasy with this subject, and rightly paranoid that relaxing the rules too much would leave the vulnerable open to exploitation and deceit.
Keeping someone alive against all hope and, especially, against their specific wishes is tantamount to torture. Let this woman, and anyone else who so chooses, end her life on her own terms. It's her life, it's her death.
Dying is hereditary - not a right.
How dare one human tell another that the right die should be decided by the courts? The courts do not have to wake every day not being able to move, breathe, or eat. In my view this is a form of torture, the patient in question is asking for help, she understands what will happen when the treatment stops, her wishes will be answered. This issue should be left to the individual to resolve, I find it astonishing how anyone could be so insensitive to block the right to a dignified death.
In the final analysis there is only one thing that is truly mine - and that is my life. By what distorted moral code does anyone presume to take away from me the right to decide whether I keep it or lose it? Did this lady ASK to be put on a ventilator, or was the decision taken for her? In either case she has the right to ask - nay, demand - that she be taken off it.
Although we cannot decide when we start our life, we should be allowed to decide when to finish it. Obviously this only applies to people of sound mind. I believe that this woman is living in misery and should be allowed a graceful exit.
Of course it is right that this woman should be able to make the conscious decision to end her own life. It irritates me to think that the medical community is depriving this woman from a basic human right. A person in such a predicament should be able to decide their own fate - concerning their own life.
There should certainly be a period set aside for reflection by the patient to give them a chance to try to come to terms with their condition. But keeping them alive indefinitely, against their will and trapped inside a body they have no control over sounds more like some grotesque form of torture.
If this is woman refusing to have her medical treatment, which is her right under the law, than the doctors are then breaking that law. The BMA has already passed a directive regarding patients who refuse treatment, that is that they must comply. They should respect her wishes and let her die with dignity, and allow the bed and the machine to be used by someone who wishes to continue living!
Shaun, Teignmouth UK
Doctors may well try to claim that their ethical training prevents them disconnecting the ventilator. However, doctors have done so in the past when a patient is in persistent vegetative state, and in no condition to express his or her wishes.
To add to Sean Eaton's comments, doctors have also been known to write DNR (do not resuscitate) on patients' records - without their knowledge - where do they stand, ethically, making those desicions? I think we have the right to determine our own fate.
Of course she's got a right to die, keeping her alive against her will is torture.
Why can't the United Kingdom simply
adopt the Dutch system?
We have been using euthanasia for
many years for our old and sick pets,
why can't that level of compassion be
extended to human medicine?
Before we rush to "adopt the Dutch system" let's remember that it includes involuntary euthanasia, and that up to 30% of Dutch patients have their lives terminated without ever asking for it. And this is according to the Dutch Parliament's own figures.
I agree with Dougie Lawson - allow her 30 days to decide and if that is what she wants then more power to her. Doctors wont allow her the option of dying but are trying to force her into a rehabilitation centre - don't the woman's needs even come into this? Are any doctors listening to what the patient wants?
I don't think the Dutch are in any position to lecture us when their barbaric system is so blatantly abused by doctors that practise involuntary euthanasia. This case has nothing to do with euthanasia: it is about refusing treatment. Any person has the right to refuse treatment, and it is an abuse by doctors to fail to comply with this wish if the person involved is of sound mind.
The comment that animals are put down so why not humans betrays the woolly thinking of the writer. Humans are not the same as animals. Animals are reared for their meat: by extension that argument could justify cannibalism.
Everyone has the right to make their own decision about what happens to their body. If you had breast cancer you would be given the option of treatment so why not be allowed to decide if you want to live or die?
If your life is being prolonged by artificial methods then the decision to end that life should be yours. If your beliefs are strong enough for you to think that you would be better off terminating your life then it should be your choice. No-one should be allowed to override your decision.
08 Mar 02 | Health
Warning over right-to-die plea
23 Jan 02 | Health
Right-to-die case fast-tracked
04 Oct 01 | Health
Woman granted right to die
06 Oct 00 | Health
Go-ahead for 'death with dignity'
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