Posted on 11/17/2006 7:54:32 PM PST by FLOutdoorsman
The Lord Chancellor has warned doctors they risk going on trial for assault if they refuse to allow patients who have made 'living wills' to die.
Lord Falconer's message to the medical profession told doctors and nurses that new laws will require them to end lives rather than save them.
Those who decline to do so will face jail or, alternatively, big compensation claims in the courts.
Lord Falconer set out the determination of the Government to use draconian penalties to enforce living wills in a guide to Labour's Mental Capacity Act for doctors, nurses and social workers.
The law, which comes into operation next spring, gives full legal force to living wills, or advance decisions, in which patients say, sometimes years in advance, how they wish to be treated if they become incapacitated and lose the ability to speak for themselves.
In a living will a patient can demand that life-preserving treatment be withdrawn if they become too ill to communicate or feed themselves.
Critics say that for this reason the new law amounts to the introduction of euthanasia through the back door.
Death for those who have asked for it usually means the removal of tubes providing artificial nutrition and hydration so that a patient dies of lack of water and food.
The guidelines issued by Lord Falconer - with the backing of Health Secretary Patricia Hewitt - say that doctors may declare themselves conscientious objectors if they have religious or moral objections to carrying out the instructions of a living will.
But in that case a doctor must pass his or her patient over to another doctor who will follow the instructions to allow the patient to die.
The guidelines tell medical workers: 'You will not incur liability for providing treatment in a patient's best interests unless you a satisfied that a valid and applicable advance decision exists.
'If you are satisfied that an advance decision exists which is valid and applicable, then not to abide by it could lead to a legal claim for damages or a criminal prosecution for assault.'
An assault prosecution would mean that a doctor who refuses to kill a patient could go to jail. Conviction for actual bodily harm can carry a punishment of five years imprisonment.
The warning over damages claims raises the prospect that family or friends of a patient who have a financial interest in their death could sue a doctor who fails to kill them. It also opens the bizarre possibility that a patient who recovers could sue a doctor for not letting them die.
The ministerial guidance on the Mental Capacity Act comes in a week when the influential Nuffield Council on Bioethics recommended that premature babies born at 22 weeks or earlier should not be resuscitated, a suggestion that led to fears that the life-saving efforts of doctors will be bound by inflexible rules.
Now the guidelines on living wills has led, critics said, to the shadow of euthanasia over both ends of life.
Surgeon Dr Peter Saunders, head of the Christian Medical Fellowship, said: 'Clinical circumstances exist where it is entirely appropriate to withhold food and fluids: for example in a dying patient when their delivery proves both burdensome and ineffective for the patient.
'But we are concerned that patients will make unwise and hasty advance refusals of food and fluids without being properly informed about the diagnosis. It is too easy for patients to be driven by fears of meddlesome treatment and "being kept alive", into making advance refusals that later might be used against them.'
He added: 'Commonly patients change their minds about what care they would like, as their condition changes.
'This law does not allow real conscientious objection. A doctor who believes it would be clinically wrong to withdraw food and fluids must pass their patient over to another doctor who will do so. That makes them complicit in the death.'
Philosophy Professor David Conway of the Civitas think tank said: 'This is opening a terrible can of worms and it threatens to cause havoc.
'It would be impossible for a doctor to treat a patient in good conscience. What is a doctor supposed to do? This runs counter to the Hippocratic Oath that some still swear.'
'The best option would be for a doctor to find out if patients have made living wills and refuse to treat those who have.'
The guidance from ministers comes amid deepening concern over the implications of the Mental Capacity Act. The Act gives statutory force to the legal precedent set by the courts which says that it can be in the best interests of an incapacitated patient to be allowed to die through withdrawal of food and fluids.
But there has been alarm at the ease at which a patient can give instructions that they should die. Under the law, a living will that entails death needs to be in writing or included in medical notes, but will still be valid if a patient is too ill to sign their name to it.
The law also allows people to nominate a friend or relative with the power to order the withdrawal of life-preserving treatment if they become incapacitated - and to do so just by ticking a box on a form.
At one hospital trust in West London, doctors have already been provided with space in patients' notes to record requests that they be allowed to die if they become critically ill.
The Health Department also made clear in a court case last year that decisons on whether to provide a patient with life-saving treatment - such as provision of artificial nutrition and hydration - can be influenced by the cost of providing treatment.
The new guidelines make clear that doctors who obey living wills and allow their patients to die will not be faced with prosecution even if it turns out that the living will was not valid or did not exist.
They told doctors: 'If you reasonably believe that there is a valid and applicable advance decision then you will not be held liable for the consequences of abiding by it and not providing treatment.'
Academic lawyer Dr Jacqueline Laing of London Metropolitan University said: 'Many people will have filled in advance decision forms in ignorance of their lethal implications and of alternative courses of action. 'The Act inverts good medical practice by criminalizing medical staff who intervene to save the lives of their patients with simple cures and, in certain cases, even food and fluids. Any conscientious opt-out is nullified by the threat of prosecution.'
She added: 'The lethal direction of the Act and the cost-saving implications for the NHS should be obvious.'
Cue the Twilight Zone theme.
It looks as if the British Labour Party has decided to move past the Netherlands in the race to revive Nazi medical practices. Hitler would have been proud of this.
It's the end of the world as we know it...I feel fine.
And so it continues...step by step, increment by increment...
No simular penalties for denying "life-preserving treatment". I wonder why?
why not just simplify things? Anyone over the age of say 70 should go there local solyent green center to met a "peaceful" end.
ahh Secular humanism,like the flu in the spring, you just keep on working don't you?
Why not let people who have a living will die like they want to?
NOOOOOOOOOOOOoooooooooooooo! Not again
National health care $$$$. Treatment to preserve life costs too much.
Why not let people who have a living will die like they want to?
Let me answer your question with a question (if you don't mind)
Should doctors be in practice to save lives or to end them?
I find it mildly amusing to watch people posting about the beginning of the end, all the while trying to impose THEIR views on others.
Doctors should do all they can to save lives; but not to prolong them when there is no hope and the patient wishes to die with dignity in a way of their own choosing.
I don't think docotors should ever administer medicines or treatment to aid a death, but if a patient chooses no more treatment, I believe it's the patient's right to choose that and the doctor should honor that choice.
Thanks for posting. Interesting.
I agree 100 percent.
Especially the "one shot" thing......LOL.
I don't find it amusing at all Howlin.
I had a good friend who died just over 6 months ago ... young. Of leukemia.
He had been through hellish treatments and resusitating procedures. He indicated, after the last one, UCLA screwed up and saved him. He was miserable after so many high tech attempts to keep him from dying.
His parents finally intervened and he was allowed to die when the time came ... again.
Modern techniques prolong a natural death. Thanksfully, this young man is at peace now.
I can understand that, too; perhaps I'm just in a weird mood tonight, never knowing what new "injustice" will pop up on FR lately.
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