Tony Nicklinson loses his case to be allowed voluntary euthanasia

The High Court has released its judgement in the case of Tony Nicklinson. It denies him the opportunity to end his life (his locked-in syndrome makes him unable to kill himself without assistance). It condemns him to an existence which neither he nor his family desires (and which he describes as one of "increasing misery", being unable to speak and barely move), and which society should not desire for him.

The judgement will almost certainly be appealed.

In the meantime, the Secular Medical Forum has released the following press release:

Today’s sad verdict leaves Tony Nicklinson with a terrible choice. Because other people regard his tortured life as somehow sacred, or are fearful of societal consequences, he is forced to endure his suffering or take desperate measures to end it. With no hope now of a quick release, he must choose between this torment and the torment of allowing his family to stand by and watch him starve himself to death. The law is failing people both ends up. People who do not want to die are not protected from unscrupulous relatives whose motives for ending their life will only be questioned when the patient is already dead. Those people, like Tony, who tell us quite reasonably why they would like to end their unbearable misery are prevented from doing so. 

I had calling from God to be a doctor, says GP who admits to shortening patients' lives

Dr. Howard Martin, age 75, has admitted he shortened the lives of "scores" of patients by administering large doses of opiate drugs (morphine/diamorphine), to enable them to die at home. He did this out of "Christian compassion":

"I don't believe I've killed any patients. I believe I've made them comfortable in their hour of need. But I am deemed to be arrogant because I used my discretion. They want to extrapolate that to say I'm choosing to kill people. It's not like that. The patients are about to die and I want to make sure they are comfortable. How can a so-called caring society not understand that? How can I be reckless with someone who is about to die?"

Dr. Martin is no doubt correct that there are serious problems with end of life care in the UK and that there is frequently a dissonance between public opinion and criminal law regarding voluntary euthanasia. However, he has also admitted that in two cases he hastened patients deaths without their permission. Professor Steve Field, chairman of the Royal College of General Practitioners, said:

"I'm horrified that the doctor seemed to indicate in the interview that he actually hastened the death of two patients without their consent - I'm speechless."

It is perhaps unsurprising that the GMC panel found that he had an "autocratic attitude" and believed he was always right.

“On Judgment Day I will have to answer to God, and my answer will be this: that I did my best for my patients.”

Dr. Martin's frequent religious references seem to indicate that there is a link between his faith and his medical care (or lack thereof, depending on viewpoint). As considered in a previous post, to make decisions using texts that exalt the stories of a group of iron-age shepherds (instead of using a process of rational and exhaustive ethical decision-making) is a recipe for poor decisions in which the patient comes second to the decision-maker's desire for supernatural approval.

For these reasons, and in spite of the importance of the topic and need for its careful reform, I find it difficult to imagine a worse medically-trained ambassador for end of life care issues than Dr. Martin.

OK, maybe one.

Justice John Paul Stevens — The Practice of Medicine and the Rule of Law

New England Journal of Medicine (free full text article) marks the retirement of Supreme Court Justice John Paul Stephens and his record of defending medicine against interference by government and other groups, including matters of abortion and assisted suicide:

Although it’s not a thought that has leapt to the minds of commentators, U.S. Supreme Court Justice John Paul Stevens will be missed by physicians and patients. Stevens believes that the Constitution prohibits government from interfering in personal decision making, including medical decisions that belong in the hands of physicians and their patients, not politicians and regulators; it was for this reason that he was Justice Harry Blackmun’s staunchest ally in upholding the Roe v. Wade abortion-rights decision.

What can be expected of his successor, Elena Kagan, here: Kagan Memos On Abortion Limits, Religious Rights