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Assisted Suicide after R V Purdy.
What is Euthanasia?
Questions concerning the rights of individuals to bring their life to an end are the subject of heated debate. Life may be brought to an end using a variety of methods including:-
1. voluntary euthanasia, where the patient asks for euthanasia and consents to the procedure.
2. non-voluntary euthanasia where the patient cannot make a decision and a decision is made whether to discontinue treatment on the patient’s behalf based on his/her "best interests".
3. assisted suicide, where the doctor prescribes lethal drugs and the patient administers them personally.
Double Effect.
If a doctor deliberately ends the life of his/her patient then the doctor will be guilty of murder. The consent of the patient in the case of voluntary euthanasia is irrelevant as is the doctor’s motive of ending the patient’s suffering. The doctor, if found guilty will receive a life sentence. However the criminal law will not automatically be concerned with all action by a doctor that bring about the patient’s death. In the case of Re J (Wardship: Medical Treatment) Donaldson MR said: "the use of drugs to reduce pain will often be fully justified, notwithstanding that this will hasten the moment of death." This is known as the doctrine of ‘double effect’
The Judiciary has shown a reluctance to accept as lawful any positive acts by a doctor to shorten his patient’s life whatever the motive. In the case of Airedale NHS Trust v Bland Lord Hoffmann stated: "No one is suggesting that Anthony Bland should be given a lethal injection…It is, I think connected with our view that the sanctity of life entails its inviolability by an outsider…human life is inviolate even if the person in question has consented to its violation. That is why although suicide is not a crime, assisting someone to commit suicide is. It follows that, even if we think Anthony Bland would have consented, we would not be entitled to end his life by a lethal injection."
Assisted Suicide.
However it is not the law relating to murder that is of most concern to lawyers and doctors when faced with questions regarding the termination of a patient’s life. The Suicide Act 1961 makes assisting a suicide a crime punishable with upto two years imprisonment. In the case of R (Purdy) v DPP the Court of Appeal held that the appellant’s article 8 rights had not been infringed by the DPP’s refusal to give an assurance that he would not bring a prosecution under S.2(1) Suicide Act 1961. However the Court did show some sympathy for the appellant and others in similar positions and laid down guidelines to be applied in similar cases. The Court stated that in future cases courts would look closely to see if a prosecution was an abuse of process and if so, they would dismiss the case. If the prosecution were to proceed the court reserved the power to exercise discretion when sentencing and to discharge the accused and also to question the decision to prosecute. Mrs Purdy subsequently appealed to the House of Lords and finally to the European Court of Human Rights. In response to the judgements of these courts the DPP issued a more detailed set of guidelines outlining the circumstances where a prosecution under S.2. Suicide Act will be brought.
Patient Autonomy.
Modern healthcare practice routinely emphasises the rights of the patient to determine what is done to his/her body and thus it is inconsistent to respect a person’s right to make decisions regarding the treatment they receive for the vast majority of his/her life only to stop doing so when that person nears end of his/her life.
However Keown states: "we do not live as atomised individuals, as much talk about absolute respect for personal autonomy appears to assume, but in community, where our choices can have profound effects not only on ourselves but on others." Therefore it may be argued that there are limits to personal autonomy and that the effects of euthanasia and assisted suicide on family members and the community at large must be taken account of. Also to give effect to autonomy would require that the dying patient could compel the doctor to carry out euthanasia or assist in his/her suicide. It would quite clearly be unacceptable to extend patient autonomy to force others to take steps to end another’s life if they did not wish to do so. Dworkin recognises the limits of autonomy: "…they have no right to compel a doctor to assist them. The right in question is only a right to the help of a willing doctor."
More articles at http://www.lawnewsuk.co.uk/
