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Monday, 25 March, 2002, 10:39 GMT
The right to die: Was it the right decision?
A woman paralysed from the neck down has been told by the High Court that she has the right to have her life support machine turned off.
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%.
Now she has been told, in a landmark judgement, that doctors do not have the right to refuse her request.
The ruling by the judge, Dame Elizabeth Butler Sloss, upholds the right of mentally competent patients to decide the course of their medical treatment.
Do you think that the High Court made the right decision?
This debate is now closed. Read a selection of your comments below.
I am so happy for you, Miss B. I wish you peace and joy for next life. For those who object - please remember you're not the one who is suffering!
I feel strongly that this is a victory for compassion and for humanity. I hope to God that it sets both a legal and moral precedent.
Marcel de Vries, Holland
Freedom is a right we all have, and freedom from Pain or suffering is a right that every individual should have if they choose to do so.
In response to the comments made by John Bailey, USA, I do agree that no judicial system should be based on any religious bias or beliefs, although in this case I do not believe it was. As for reverence for human life, surely no matter what race, religion, beliefs, any moral individual regards human life with respect? I do believe every individual of sound mind has the right to make their own decisions based on their own beliefs. As a Catholic/Christian I take offence to my own belief being referred to as an 'imaginary deity'.
Whatever happened to 'No man is an island....' and the notion that I am diminished by the death of another? Those with a totally selfish and anti-life mentality are using this tragic and moving case to push their agenda for a loveless and merciless world. How soon will someone else's 'right to die' become my 'duty to die'? Thousands are euthanised in Holland without their approval, and depression and simple 'weariness of life' are grounds for death. God save us from this reign of Death in our culture.
I would not like to be the doctor who pulls the plug.
Whilst I empathise with Ms B's point of view, I think that today's ruling is disgraceful. I do not agree that people have the right to choose when they die. The repercussions of this ruling could be that the NHS withdraws treatment to people in need - after all, wouldn't it save money and cut waiting lists? Society should be supporting vulnerable, depressed people. Many people of sound mind attempt to kill themselves every year and we don't tell them to go and take a running jump. I have personal experience of severe disability - it's not easy, in fact it's very difficult, but everyone's life has value.
I fail to understand how Ms B says that she doesn't want to switch off the ventilator herself as that would be suicide - when in fact that's what this ruling is - let's call a spade a spade. The plain fact here
is that the judge has ruled that a disabled person's life can't be worth living - would we really let a 21 year old man of sound mind withdraw treatment so as not to recover from an overdose?
It worries me that this ruling has been made by Dame Elizabeth Butler Sloss partly on the assumption that the patient would be better off dead - can she really make this judgement? It also worries me that the patient refused not only the option of committing suicide but also of being weaned off the ventilator - still it has been decided that death is definitely what the woman wants.
I won't argue with someone's rights over what they do with their body whether alive or dead. However has any one thought about the distress a decision like this can cause family members?
My father had kidney failure and received good and caring treatment but two or three times when he was feeling very down and ill toyed with the idea of discontinuing his treatment. While I understood how he felt, it was very distressing for me to have to go into all the details about how he would die, so I just ask any one who is contemplating ending their life by choice in this manner to give their family some thought.
We need to look at such matters outside religious blinkers-what right has anyone to try to impose their beliefs and to say that this person should live in her tragic condition - would they be content with just lying in a hospital bed for the rest of their life....
Chris Jenkins, England
To me it's quite easy - we see the obvious advantages in putting suffering pets 'to sleep'. Why then, should some patient being of sound mind, if not body, not be permitted? Should we say that the rules are different for humans? Quite the contrary - we are the only living animals with the power to reason.
Where is freedom when you cannot chose if you want to die? Everyone else can decide to kill themselves, why not when you need some help to do it? It is discrimination!
Wayne Spring, UK
I'm very pleased for this woman and I hope her case goes someway to helping that of Diana Pretty's.
All patients have the right to refuse treatment and even to insist treatment is discontinued, although this will inevitably lead to death. However, no one - patient, doctor or judge - has the right to make any doctor terminate the life of a patient by their actions
There is a difference between going out and killing a healthy human being and keeping a seriously injured and suffering human alive using artificial means. Medical science should be used to reduce suffering, not extend it.
I, personally, have no point of reference from which to make any judgements on Miss B's case.
I have never suffered pain that would cause me to consider death, nor do I need assistance to live as Ms B does. Lachlan's point regarding the right to refuse treatment (or assistance in Ms B's case) versus actively killing one's self is very pertinent. This right of choice, the freedom with which to forge one's own destiny, I would say, is one of the tenets of our society.
Paul Stevens, England
I don't believe in the right to die. However as someone forced to endure apathy and depression brought on by supposedly life-preserving medication I fully support the right of a sound-minded person to refuse medical treatment. I stopped taking the medication and am still happy and healthy 6 years on.
I believe the right decision was made today. The woman has the right to refuse treatment, whatever the outcome of that may be. Just think: as little as 30 years ago she would have died as a result of her trauma and while medical science has made leaps and bounds in some area it also prolongs life when there is no quality of life worth living. You would not treat a dog in this way. This ruling will protect doctors because as long as doctors follow guidelines and rulings of both the courts and the GMC then they have done nothing wrong.
J. M. Shepherd, USA
The judge's ruling is absolutely right. If we are free people with free choice then we should be allowed to express the ultimate choice, that between life and death. The right to choose when your life should end should be up to you and no-one else.
I don't believe that this case is about the right to die. It is about the right for an adult of sound mind to refuse any medical treatment even though they may die as a result. Doctors do not have the right to administer treatment to people who have decided they do not want it.
A very sensible and humane decision. None of us who are able-bodied can consider the pain and suffering of someone who is completely paralysed and unable to do anything except lay there. It takes a woman judge to show compassion and come to a sensible decision.
Aaron Baker, Canada
One person has commented here that they have a disability and they want to live life to the full and another has said that it's god's right to choose. There is one fundamental point in this whole case which covers those two points - she cannot breathe without the help of a machine! How can she live life to the full being connected to a machine! Surely god has already decided. All she is asking is for the doctors to stop intervening by switching the machine off and then god will make his decision.
What a brave lady! The right decision was made. Informed Consent is the key. As Doctors we cannot impose treatment that is not wanted. Without informed consent, this treatment becomes assault. We may disagree with a particular patient's choice, but I would always defend a patient's right to make that choice. Every day I see patients who choose to smoke, or who do not take their angina medication, and I know that this is going to lead to further health problems. But I have no power, and neither should I have, to force them to take that treatment. Ventilation is no different. I agree that a temporary depressive illness may affect a patient's ability to give informed consent, but by all accounts, this brave lady was as rational as anybody could wish to be.
Despite this ruling few doctors in similar situations will accept the individual responsibility of withdrawing treatment from a patient who could later be diagnosed as chronically depressed. The doctors would then be put in the invidious position of having to defend their actions - and possibly even face murder charges. Doctors need protection in cases like this. That said the High Court is an extreme and expensive form of protection.
James Miller, UK
My heart goes out to this woman and I wish her peace and joy in this life, or the next.
I would like to congratulate Ms B on this verdict, I hope that now she and her loved ones get the peace they deserve.
No one should give ruling/decision for someone to die in such cases, but to just wait for her turn to come. Unless in cases of murder where the court will give its ruling.
It seems impossible to believe that anyone should be denied the right to die at a time of their choosing, even if they are disabled, perhaps even more if they are disabled. A well man is legally able to commit suicide so why should a sick person be prevented doing so. It seems that our laws are still carrying the baggage from the days when a religion could deny individual freedom.
Nicola Allen, UK
She should be allowed, as well as all of us, to decide if we want to live or die!
Suicide is no longer a crime, and while doctors have a duty to sustain life, in these kind of situations
A person of sound mind should be allowed to make their own decisions, including a decision on their own life.
The patient should have the right to die if that is their choice and free will. We have the freedom of choice in what we do in all other aspects of our lives so why not this? The choice should not lay with some third party that doesn't feel any of the physical or mental anguish of these patients' conditions... It's time these ridiculous laws were changed...
The patient should have the right to decide whether he/she lives or die.
If one who is healthy has the right to jump out of the building ... why shouldn't the one who's in hospital bed has the right to decide as well?
She should be allowed to set her affairs in order and then do with her life as she wishes, so long as it harms no other.
You cannot persuade me that it is wrong to allow someone who is suffering to choose to end his or her life. Mental and emotional pain is as bad as physical pain; just because the body can still function does not mean it should be forced to. To deprive someone of the right to end their life under conditions that they find unacceptable is tantamount to forcing them to endure torture.
Nobody should be allowed to decide to die. Everyone should help others to live as long as the nature calls.
It is a sad case which will never be settled from a social standpoint. This woman should be allowed to die if that is her wish. It has been medically acknowledged that her prognosis is less than 1%, and she is on a ventilator. It should be her decision. Over here, we have already been through this. The result was that it is legally wrong. To enstill this in the general public, they made an example out of the only doctor who was willing to raise the question of life or death. Personally, I think they made an example because otherwise if doctor assisted deaths were legal; the large insurance companies would have to pick up the tab.
At minimum the terminally ill patient or the person with the prospects of a very dismal quality of life should have the liberty to exercise their autonomy in choosing to end their lives. Involuntary euthanasia is a more difficult ethical issue because the patient is not making the actual decision. But the issue of quality of life should be a genuine consideration when allowing people to legally end their own lives.
I too have a spine injury! However, given time, I came out of the deep depression which comes soon after the occurrence. And in that depth of depression one cannot see clearly. So it is a shame, that one might in its depth, decide to die. As now I have come to challenge the disability, and live life to its fullest, regardless!
Gretchen , USA
The right to die should be hers alone, I know if I was in her shoes I would demand to be left to make my own decision
Yes under strictly controlled conditions with independent evaluation to ensure the certainty that that person wants to die - preferably then agreed by a judge or someone similar.
I fully support euthanasia. There are times when an animals life is valued more than a human, if a dog or any other animal is suffering it is put out of its misery, so what is the difference. Why should humans be made to suffer with terminal illnesses?
It's a 'no-win' situation for anyone involved. One has to feel sympathy for the judge who is being asked to rule on this.
Lachlan McLean, Law Student, Cambridge University
I am shocked that a nation of your sophistication would be so cruel and unkind to a paralysed woman wishing to be disconnected from life support. It is a shock, really. England is considered to be a bastion of social advance, indiscriminate compassion, and moral conscience. This scenario would never exist in an American hospital. Our society would guarantee her right to die, and a peaceful death at that. Self-determination is a tenet of humanity. How can you people not know that?
I have just had to watch my Grandmother suffer for over two years and slowly die from Motor Neurone Syndrome, after months of not being able to move or talk. It was the hardest thing I've ever had to do, knowing how much she wanted to die, but not being able to help. To be a prisoner in your own body is torture and a person with a sound mind should be able to decide when to be released. If they were pet animals they would be put to sleep, that being the most humane thing to do. Why do we force people to suffer in such an inhumane manner?
Louise, Sydney Australia
Euthanasia is a crime, and a crime that can be induced by unscrupulous people. I guess its just one persons retort to malpracticing Doctors who couldn't be sued!
The issue of who has the right to decide whether a person lives or dies will always be emotive. There are two sides to every coin. Health care professionals are in the business of saving lives and so this presents them with an ethical dilemma. The woman appears to be psychologically sound although I understand that she has displayed ambivalence on several occasions when her ventilator could have been turned off. Every case needs to be looked at on an individual basis and the decision should be based on its merits. This woman's condition will not improve and if she is weaned from the ventilator as suggested, she will be sedated but have no control over her pain. If health care professionals are to engage in true holistic care then they must also respect the individual choices that patients make however difficult or conflicting it is with their own personal beliefs.
Just as you have the right to live I think you have just as much right to die. It is stupid, selfish and a breach of human rights to deny someone of the right to die.
This is a really sad case. The lady in question clearly is fully aware of what she asks. Doctors can't be allowed to play God, and keep her alive just because they have the knowledge to do so.
It is very hard to determine because it may transform the decisions of life for all future patients suffering from same conditions and shall be going to change the history of medical science. As a human being we don't have right to decide whether one should live or die. It is our duty to defend with all our efforts to preserve the human life.
After a work accident where I sustained serious neck injuries and was paralysed for seven months left side, now 5½ years later I'm trying to rebuild my life, at times it seemed hopeless but I must try. I have frequent relapses and sadly I am now experiencing feelings of loss on my right side. One day at a time Miss B. It's a long wait while worthwhile technology is found that can help, given time you may find a quality of life better than today; isn't it worth a try? Life is ALL we have.
Surely Dame Butler-Sloss will rule in favour of Miss B, having considered in whose best interests it would be to keep this woman alive. Let's hope she is able to give this woman some dignity and respect and let her refuse treatment.
If this was a case about 'right to die' then I do not believe that we should intervene. But surely this is a case of the right to refuse treatment (which may, or may not, lead to death) and we all have a right to refuse treatment.
In war, my death and that of many thousand others is at the whim of a few corrupt power mongers. No individual worth. My Life and that of many thousand others can rest on the profit motives of drugs companies. No individual worth. If I want a say in my life, it becomes a sacred gift which I have no rights over. What hypocrisy.
Nathan Ross, Australia
If a person has been kept alive by artificial means, and they wish those means to be withdrawn then I believe they have that right.
However, if it were the case that the doctors would have to perform some action that would actively terminate the patient's life (as opposed to withdrawing support), I believe nobody should be allowed to choose that option.
Kirsty Mackenzie, Scotland
I strongly believe the individual has the right to decide whether they wish to continue with their life.
I appreciate that doctors have an obligation to try to prolong patients' lives but if a person feels he or she no longer has an adequate "quality of life", then the doctors cannot be allowed to overrule this.
If I am to be responsible for my life I am responsible for my death.
If you can't control the outcome of your own life, then who can? The government? Any person has a right to do whatever they feel necessary.
No government should be permitted to substitute its judgement for that of an individual about what his or her moral, religious, or ethical beliefs are about life and death (so long as in doing so, the individual does not harm others, or force others to help them die).
Rob Bowling, United States
Anyone wishing to change the law on euthanasia should read Ian McEwan's book "Amsterdam". A chilling account of the relaxed laws in Holland allowing two perfectly healthy people to euthanise each other. Do not change the laws.
Right to die? Who knows what that phrase means? And what could possibly be worse than having a government ... any government decide?
Everybody should have the right to die in a dignified way.
Jon Bailey, USA
Well of course she should have the right to die. I might not choose to die in her place, but that doesn't mean I have a right to impose that on her. Religion seems the only thing that would oppose her choosing that, and I thought that was supposed to be separate from government or law.
Since the legal issue is one of competence, and the patient seems to be competent, it looks as though she should win her case. If the doctors concerned are unwilling, for personal moral reasons, or for supposedly professional ethical reasons, to shut off the machine, then someone else should be permitted to do it. Those doctors who refuse to do this for personal moral reasons or who refuse others to do so, are the ones who are, in that odious phrase, 'playing God'. This phrase is odious because it assumes that the life of the competent person in question truly belongs to God - contention that is precisely the one often at issue in such cases. But this cannot be assumed in a secular society. So, as far as public policy is concerned, refusing to allow the machine to be switched off in such circumstances is a matter of those in charge simply imposing their preferences on the patient - an act of arbitrary power. This cannot be right.
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