The Director of Public Prosecutions (DPP) has published his interim guidelines on when to prosecute in connection with assisted suicide. In effect, he has set out the circumstances when a prosecution is “unlikely”. Thus he has provided a frame within which individuals can avoid conflict with the law. He has created a special category for spouses and those not motivated for gain but by “compassion”.
There are many objections to this approach, including a lack of clarity as to what constitutes assistance. The BMA have objected and pointed out that it is a threat to the doctor patient relationship. The MDU have advised doctors not to cooperate or even discus assisted suicide with their patients.
Apart from the obvious reluctance to bring a case to court, there are likely to be great evidential problems as the main witness is dead and it is not possible to know what passed between them and their helpers. The interim guidelines represent an outline defence to those at risk of prosecution.
A consultation process was opened to the public and the MEA sent a strongly worded warning that this approach was so open to abuse that it represented a threat to vulnerable and elderly persons.
Meanwhile, the record shows that none of the 115 suicides of UK citizens in Switzerland has resulted in a prosecution. It is increasingly unlikely that anyone will be brought to trial and more cases probing the law are likely to occur in this country. The DPP appears to have ignored recent parliamentary votes against assisted suicide one as recent as last year. As the Care not Killing coalition, to which the MEA belongs, has pointed out a few determined individuals are coming to pose a danger to a huge number of vulnerable people. The law is effectively being made by a law officer.
The Liverpool Care Pathway
There has been criticism of this pathway for the terminally ill in the national press. One letter, also signed by the MEA, pointed out that the pathway can be misapplied to the non dying with lethal effect and that diagnosing imminent dying is not an exact science. This was followed by many letters from members of the public which gave instances of relatives who had been put on the pathway and who survived for long periods when eventually removed, often after prolonged pleading with medical and nursing staff.
The pathway has been updated and now includes more references to training and discussion but has still left open one of the most contentious issues, namely whether fluids should be withdrawn, The MEA have consistently said that there are practically no circumstances when oral fluids should be stopped and we think that fluids should be given by other means where there is a danger of opiate derivatives and dehydration causing terminal delirium. We are also concerned about the use excessive sedation which deprives a patient of consciousness.
The result of this controversy is that some patients will refuse the Liverpool Care Pathway in an advance directive. We know of two organisations producing cards or bracelets refusing it.
The problem seems to have arisen because the pathway, developed in hospices for people with end stage cancer has been applied in other circumstances where imminent death is not inevitable.
The Archbishop of York, commenting on a spate of disciplinary actions against employees for expressing such benign sentiments as a willingness to pray for a sick person , and have been subject to suspension or brought before employment tribunals.
The Archbishop of York Dr Sentamu said;
“Those who display intolerance and ignorance, and would relegate the Christian faith to just another disposable lifestyle choice, argue that they operate in pursuit of policies based on the twin aims of “diversity and equality”. Yet in the minds of those charged with implementing such policies “diversity”, apparently means every colour and creed except Christianity”.
Baroness Warsi, Shadow Minister for Community Cohesion and a Muslim said,
“It’s an agenda driven by the political-elite, who have hijacked the pursuit of “equality” by demanding a dumbing down of faith. It’s no wonder that this leads to accusations in the media that our country’s Christian culture is being downgraded”
Baroness Scotland the Attorney General said that,
“Faith isn’t an optional extra or something that you put on, like a hat on Sundays, and take off for the rest of the week. It goes through you like a stick of rock. It is reflected in what you are and what you do”.
Caroline Petrie, a Christian nurse from Somerset was suspended for offering to pray for a patient but was ultimately reinstated after a media campaign. A Christian registrar was threatened with the sack when she asked for her religious beliefs on same sex unions be accommodated. Her case has gone to the Court of Appeal after lawyers for her said that she had been the victim of a “witch hunt” when her case was before an employment tribunal.
In general terms , the MEA have always taken the view that a patient’s spiritual needs should be addressed in their care plan. And that a religious history should be part of normal health documentation.
Government’s abortion guidance in Northern Ireland challenged
Despite abortion being illegal in Northern Ireland government guidance called for medical providers to give
non- directive counselling to women who might be considering abortion.
The Society for the Protection of Unborn Children (SPUC) successfully appealed against this in the Belfast High Court arguing that because abortion remains illegal in Northern Ireland it was wrong to expect medical providers to give such counselling and the guidance was also wrong regarding non-participation in abortion (conscientious objection ).
The judge ruled in favour of SPUC on both matters and ordered cost against the Northern Ireland Department of Health, Social Services and Public Safety.
Please see separate paper on two recent books by Dr G Craig
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