The ProLife Alliance welcomes today’s judgment which will protect the life of a 53 year old woman with minimal consciousness, known only as ‘M’.

In 2003 ‘M’ suffered brain damage, although she is not in what is called a “persistent vegetative state”, or PVS.  She responds to touch, can make some arm movements, and shows other interaction with her carers.   

Family members made an application to the Court of Protection for her food and hydration to be withdrawn to bring an end to her life.  The Official Solicitor and the family’s local NHS Trust opposed the application.  

An attempt by the ProLife Alliance to intervene on behalf of ‘M’ was declined.  We are grateful to specialist Court of Protection barrister Laura Davidson for her advice and assistance on our proposed intervention.

We applaud today’s decision that the court’s reasoning adopted in the Tony Bland case cannot be extended to patients who are in a minimally conscious state.  It would have been an outrage to human decency had the court granted the application and the declarations sought, and a failure by the state to protect society’s most vulnerable.  Such a decision would have been a flagrant breach of human rights, including both Article 3 of the European Convention on Human Rights (the right to freedom from torture and inhuman degrading punishment or treatment), as well as the right to life under Article 2 – in essence, an endorsement of murder.

We would also like to draw attention to the United Nations Convention on the Rights of People with Disability, signed by the UK in 2009. Article 25 (f) of this Convention state that parties to the Convention must take "all appropriate measures" in particular to "prevent discriminatory denial of health care of health services or food and fluids on the basis of disability". 

A helpless patient should be entitled to be fed, given liquid, kept clean and pain-free, and treated medically insofar as it is helpful.   These are basic human rights which the courts have disgracefully denied to some 42 patients since the Bland case in 1993.

It should be noted that astonishing recoveries from serious cases of brain injury are not unknown, including that of Richard Rudd, who had locked-in syndrome and indicated by blinking that he wished to remain alive only hours before his life support machine was due to be turned off.

In welcoming this judgment we must now turn our attention to the original Bland decision and work to have this reversed by Parliament so that the human rights of all vulnerable patients are properly protected.

We tried to intervene in the case, believing that our knowledge and expertise would aid the court in its decision-making.  Unfortunately the Official Solicitor, the relevant NHS Trust and family members opposed the intervention.  

We sincerely hope that the judge will rule that the woman, known only as M, should not be killed through the removal of fluids and food, an inhumane and painful death, especially for someone who has demonstrated that she is able to understand requests. She has also demonstrated happiness at seeing certain people and has spoken. 

The ProLife Alliance believes that the right to life is a fundamental human right, regardless of a person's abilities, and should always be protected.

We will share information on the judgment when we have it and will be issuing a statement. 

Mrs Dominica Roberts, the alliance’s chairman, said: “If the court gives in to Martin’s request, it will place many more vulnerable people at risk. The long-term ill will feel under pressure to commit suicide or be killed, and the medical profession’s fundamental ethics will be compromised. The Dutch experience shows that euthanasia regulations are widely ignored. We do feel for Martin and his family, but the priority must be making his life as comfortable as possible.”

Martin, probably not his real name, has been paralysed since a stroke three years ago, and can only communicate through eye-movement and computer interaction. He is not close to death.  

The ProLife Alliance is on (020) 7581 6939.

What appears to be a condition with no light at the end of the tunnel, can sometimes reverse as is shown to two stories which the Sunday Times published on 17/7/11. The stories highlight how little medical understanding of minimal consciousness there is.

The newspaper reported the very moving story of Martin Pitorius, who was considered without hope of recovery. He was subjected to terrible abuse from his carers. He was fully aware but unable to communicate. Then, with the help of a very enlightened physiotherapist, he started to improve and learn to communicate again. Mr Pitorius has written a book about his experience called ‘Ghost Boy’. He remains very optimistic about life. He married two years ago, which is surely a sign of that positive attitude.

In the same issue, the Sunday Times reported the story of Nikki Kenward, who has also made a remarkable recovery from near total paralysis in which all she could do was wink one eye. Ms Kenward has decided to protest outside the court at today’s hearing. She feels strongly that if the court decides that M should be killed, it will open the flood gates and will people who are fully conscious but unable to communicate will be at great risk. The ProLife Alliance agrees.

By contrast, in today’s Times (19/7/11), Tony Nicklinson says ‘For pity’s sake let my wife kill me’. The tone of the article is that his life is worthless. Mr Nicklinson’s case is different from M, Nikki Kenward and Martin Pitorius as he has always been able to communicate, even though with the aid of electronic devices. Mr Nicklinson is clearly in a very depressed state.

It is interesting to contrast the attitudes of Mr Nicklinson and Mr Pitorius. One seeks help to die, the other communicates far and wide, starts his own business, gets a dog and finds a wife. The ProLife Alliance agrees that Mr Nicklinson seriously needs help, but he appears to be looking in all the wrong places and finding only those will reinforce his negative state of mind, such as the pessimistic proponents of euthanasia and assisted suicide.

Professor Keown spoke of unmet needs for care and pain relief, and argued that the ethical duty to provide it was clear under any philosophical system, whether Utilitarianism, Principlism (the principles being autonomy, non-maleficence, beneficence, and justice) or Natural Law.

He cited the 2010 Montreal Declaration on inadequate pain management, and various agreements outlawing torture, in claiming that there is an international human right to preventative, curative and palliative health care.

He said that under British civil law, and that of the Commonwealth and USA, when a patient was unnecessarily left in pain, in theory an action for negligence would lie, since a breach of a duty of care causing loss or harm could be proved, although he knew of no actual case being brought. This could be against a doctor, or vicariously, and possibly directly, against a hospital or care provider.

In criminal law, it was clearly established by Mr. Justice Devlin’s clear exposition in the Bodkin Adams case 1957 that a doctor may legitimately give all necessary pain relief even if, as an unintended but unavoidable side effect, it shortens life. (Oncologists now believe that properly administered relief does not in fact usually do that.) In the case of Dr. Nigel Cox, convicted of attempted murder of a patient in 1992, the judge went further and stated there was not just a permission but a duty to alleviate pain.

For those with a duty of care to children and young people, to the mentally incompetent and even to animals, wilful neglect is a statutory criminal offence. Professor Keown suggested that there was a need for these provisions to be extended so that a person who ill treats or wilfully neglects any person in his care commits a statutory offence.

It was generally agreed that universal access to the best palliative care, not only for physical but for mental and spiritual needs, in all kinds of suffering, is the best answer to requests for any form of euthanasia, and should be available as soon as needed, not just when death is imminent.

The Court stated that there does appear to be a right to suicide implied in Article 8. In 2002 it approved the right of a British woman Diane Pretty, to kill herself if she found life undignified and distressing. But most member states give the right to life more weight than the supposed “right” to suicide.

57-year-old Swiss national, Ernst G. Haas suffered from a serious bipolar affective disorder for 20 years, has twice attempted suicide, and now wants to kill himself with sodium pentobarbital, a prescription-only drug. After attempts in Swiss courts to obtain it without prescription, and a staggering 170 psychiatrists having apparently refused to prescribe it for him, he argued in the European court that Article 8 imposed on the State a “positive obligation” to create the conditions for suicide to be committed without the risk of failure and without pain.

The Court pointed out that “a prescription system is supposed to protect vulnerable people from making hasty decisions and to prevent abuse”. That was all the more true in a country such as Switzerland, where assisted suicide is legal. It also declared that the risk of abuse inherent in a system which facilitated assisted suicide can not be underestimated. That is why a prescription from a doctor and a psychiatric examination to ensure free will were proper safeguards.

The Swiss are reported to be considering tightening up their law on assisted suicide, of which the Italian lawyer Minelli has taken advantage at his sleazy Dignitas operation.

It is the latest in a long line of legislatures which have resisted the persistent attempts of the pro-euthanasia lobby. The more closely people look at the dangers of relaxing the laws, the more they see that it would inevitably lead to serious abuse as in Holland, Belgium and Oregon. Large numbers of the handicapped, chronically ill and very elderly would have been put at risk.

A spokesman for the ProLife Alliance commented that this was a vote for commonsense and respect for human lives.

The committee report had comprehensively dismissed many of the euthanasia lobby’s usual list of arguments. It found that the law is not in need of clarification, that individual autonomy must be tempered by the effect on society, and that it was impossible to reconcile opposing definitions of “dignity” or to produce objective meanings for “intolerable” suffering or “terminal illness”.

It has happened again and again, in legislatures in the UK and worldwide, that the pro-euthanasia lobby have claimed support for their position on the basis of slanted polls and superficial emotion, but when a clearer look is taken, the dangers of changing the law which at present protects the disabled, chronically ill and vulnerable elderly become clear.

The Scottish committee discussed and rejected many of the usual arguments. They found that the law is not in need of clarification, that not prosecuting every single case did not mean condoning an illegal act, that individual autonomy must be tempered by the effect on society, that it was impossible to reconcile opposing definitions of “dignity” or to produce objective meanings for “intolerable” suffering or “terminal illness”.

A Jewish spokeswoman giving evidence had called for “good English words” such as “killing” and “murder” rather than euphemisms such as “end of life assistance”.

The full text of the report can be seen on this link.

Mr Nicklinson, who suffers from ‘locked-in syndrome’, is not terminally ill or in great pain but says that he is fed up with his life and cannot face spending the next 20 years or so in his present condition.

His lawyers have asked the High Court for a judicial review from the Director of Public Prosecutions Keir Starmer on ‘consensual killing’, and for guidance on whether it is always in the public interest to prosecute in such cases. Failing that, Mr Nicklinson would challenge the Ministry of Justice to review its application of the murder law in cases of so-called ‘mercy killing’.

Last night the Crown Prosecution Service ruled out new guidelines for ‘mercy killings’.

A spokesman for the ProLife Alliance said:

“This is the most frightening attack so far on the current laws governing euthanasia in this country. As Mr Nicklinson cannot do anything himself to take his own life, this would not be a case under the law of assisted suicide but of murder. While we have made clear in the past our opposition to the DPP’s guidelines on assisted suicide, they would not apply in this situation.

Attempts have been made in the past to legitimise ‘mercy killing’ but have rightly been rejected by the Law Commission. Hard cases make bad law and we simply cannot endanger the lives of thousands of vulnerable people in the interests of a tiny minority by sending out the message that it is permissible in certain circumstances to actively kill someone. A ‘right to die’ would rapidly become a ‘duty to die’ as the disabled would be made to feel that they are a burden on resources.

We call on Keir Starm to hold firm and reassert that the law as it stands is fit for purpose.”

This case follows that of Richard Rudd last week who was able to communicate his wish to live as doctors were preparing to switch off his life-support machine by blinking his eyes. His family believed that they were following his wishes as he had said, before the motorbike accident that left him paralysed, that he would not wish to continue living in such a condition.

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ProLife Alliance
PO Box 13395
London
SW3 6XE

Tel: 020 7581 6939
Fax: 020 7581 3868
E-mail: info@prolife.org.uk
Website: www.prolife.org.uk

The majority of MSPs are opposed to plans to allow terminally ill people to seek a doctor’s help in dying. An anonymous survey of two-thirds of MSPs carried out by BBC Scotland showed 17 supported the bill, 53 were against and 20 were undecided.

http://news.bbc.co.uk/1/hi/scotland/8477542.stm