Euthanasia: "Mercy killing" law to be tested
The case of Tony Nicklinson will re-open the debate on assisted dying and so-called "mercy killing". He has locked-in syndrome, following a stroke. Unable to talk, he communicates by blinking or nodding his head. He also has a specially adapted computer with a push-button control.
Mr Nicklinson is not able to travel, but I met his wife Jane and daughters Beth and Lauren at their solicitors in London. Mrs Nicklinson read out a statement that he had dictated to her:
"I am a 56 year old man who suffered a catastrophic stroke in June 2005 whilst on a business trip to Athens, Greece. It left me paralysed below the neck and unable to speak. I need help in almost every aspect of my life. I cannot scratch if I itch. I cannot pick my nose if it is blocked and I can only eat if I am fed like a baby - only I won't grow out of it, unlike a baby. I have no privacy or dignity left. I am washed, dressed and put to bed by carers who are, after all, still strangers. I am fed up with my life and don't want to spend the next 20 years or so like this. Am I grateful that the Athens doctors saved my life? No I am not. If I had my time again, and knew then what I know now, I would have not called the ambulance but let nature take its course."
Mr Nicklinson wants his wife to be allowed to inject him with a lethal drugs dose without the fear of her being prosecuted for murder or manslaughter. As the law stands, that seems a vain hope because actively taking a life, even with consent, has always been treated as a crime, leading to a jury trial.
The Director of Public Prosecutions recently issued new guidance on assisted suicide, but made it clear it did not apply to cases where someone directly ended another's life, sometimes called euthanasia or "mercy killing".
The guidance on assisted dying followed a victory by campaigner Debbie Purdy, who wanted to know if her husband would face charges if he helped her travel abroad to die. The DPP said each case would be examined on its merits, but if the victim had a settled wish to die and the person assisting the suicide was acting out of compassion, then it might be against the public interest to prosecute.
That's the reason why no relatives have been prosecuted after travelling to Switzerland to support loved ones dying with help of the Dignitas group.
However, when it comes to euthanasia or "mercy killing" it is down to juries to decide the fate of the accused. In two cases earlier this year, juries came to different conclusions.
Kay Gilderdale, who helped her disabled daughter to die, was cleared of attempted murder. The court heard that her daughter Lynn had a settled wish to die and had attempted suicide.
But another mother, Frances Inglis, was convicted of murder and given a minimum term of nine years after injecting her brain-damaged son with a lethal dose of heroin. Her son Thomas was unable to communicate his wishes.
In this latest case, the DPP is probably unlikely to want to further clarify the law. He did so in the Purdy case only after defeat in the House of Lords. If, as likely, he argues that the law on murder needs no further explanation, then the legal team representing the Nicklinsons will seek to make a claim under the European Convention on Human Rights.
They will contend that the law of murder in England and Wales, which prohibits all intentional killing regardless of the victim's wishes, constitutes an interference with the right to respect for private life under article 8 of the Convention.
The Nicklinson case has strong similarities with that of Diane Pretty, who had motor neurone disease. She asked the DPP to grant immunity from prosecution to her husband if he assisted her suicide. She died of natural causes in 2002, just a month after judges in Strasbourg ruled against her. Her legal battle had lasted for several years.
The case of Tony Nicklinson will inevitably provoke strong opinions both in favour and against assisted dying, and it may also take a long time to work its way through the courts.
update: July 21st 12:50 I contacted the solicitors Bindmans, who represent the Nicklinsons. I asked them to draw the family's attention to the comments regarding technology that might aid Tony Nicklinson in communicating. Bindmans have sent me an email saying this:
Jane has asked me to thank you for the blog. She said: "We actually have one of these computers on order. We had a fight to get funding but won in the end. It will be an improvement no doubt."
~RS~q~RS~~RS~z~RS~49~RS~)
I'm 
© 2012
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It's a highly emotive issue but this is a dreadful case. It seems that by a rigid adherence to the law this man is comdemned to a life of torment. He's also being discriminated against on the grounds of his profound disability. It must feel as though he's being mocked and patronised by a society that says "your family are only protected if you take your own life ..... oh - you can't manage that - tough luck mate".
I wonder what the position would be if he was given an automated drip system with a computer control which allowed him to override safety features and administer an overdose? Since the equipment would have been provided (and possibly developed) specifically to allow him to kill himself would the providers be liable to prosecution?
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I hate to comment on this subject, but Helen's suggestion seems the right one. As far as I've heard, only about one in 20 suicide attempts are actually successful. If the person could actually push the button themselves so to speak, I think this would be significantly different to the person asking another person to kill them. In my view there is a world of difference between someone taking an unresearched overdose by mouth, and someone jumping off a very tall building. Telling a carer you want to die may be more like the former, whereas pushing a button you are certain will kill you is more like the latter. Of course I'm speaking generally and not about the people in this case specifically.
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Fergus,
I don't know if you've had any direct contact with the family, but have you suggested the use of Eye tracking and speech synthesis technology as a way for Mr Nicklinson to regain some of his lost independence?
Part of his despair is due to a perception of himself as being a burden on other people and feeling helpless to do anything about it. Maybe empowering him to at least use a computer, speak and write for himself would give him hope that he might yet have more to give. With the media coverage he's currently getting, for instance, this would be a great opportunity to start a blog or opinion column.
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Each individual faces disability form their own view. The problem becomes one of setting some standard whereby some level of disability justifies termination of life. If one believes that life is sacred the question is moot. If not, the legal aspects of definition and autonomy must be adressed. Many advances have taken place in technology that support the daily living for individuals with disabilities but that individual must desire to use such devices and accept certain limitations related to control of their environment and even their body. These issues are usually based in the psychology of the individual and not so much on the physical limitations. There are many people dissatifed with their life situation and would rather it end but that is not a disability issue and disability should not be the determining factor.
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Re PaulR's comment, if it's possible for him to produce text he could also get to know people in internet chatrooms (particularly IRC), for example people on a depression or suicide related chatrooms that it might be easier to relate to.
From a technology point of view if you've got a machine that can produce a stream of text, it's definately doable to interface this to IRC (I'm an electronic designer myself), and there's a whole world of people out on IRC. Though in my ignorance of the case I don't actually know if the person in question is still able to read text on a screen or hear words read out by a computer.
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"Part of his despair is due to a perception of himself as being a burden on other people and feeling helpless to do anything about it. Maybe empowering him to at least use a computer, speak and write for himself would give him hope that he might yet have more to give. With the media coverage he's currently getting, for instance, this would be a great opportunity to start a blog or opinion column"
The poor man cannot even go to the bathroom without someone having to wipe for him. He can't lift a spoon or hold his children. He is unable to scratch his nose. But its okay... he can start a blog.... wow... some form of life that would be.
It should be his choice, and his alone. He is in his right mind, he wishes to die. Who are we to keep him in the prision of his own body??
Few very few of us understand the pain his family go through and even less of us understand his personal hell. So why do we continue to force our opinions on the poor man?! Murders are allowed out of prision early, this innocent, good man has a life sentence, and your coming up with ways to make it longer.
Being able to make a blog pales in comparision to kissing his children good night or holding his wife. If he wishes to die, who are we to tell him he can't???
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This comment was removed because the moderators found it broke the House Rules.
i can completly empathize with this man because in my family we have huntington chorea. It is a hereditary form of parkinsons that eventually leave me imobile. I watched my uncle get worse. It begane to show when he was 50 and by 57 he needed caregivers 24/7,by the time he was 69 he was bedfast and eventually died that year. I know the big problem here in the states is everyone is a "Christian" and they thinks its a sin. I dont think you should let someone suffer becuase of your ideals of morality. I am only 20 now but i have made up my mind when it is my time for the diasese to come i will commite suicide. Its not that i hate life i love it and that is why dont want to live that away. Its inhumane to make someone suffer.
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Nightwolf, #6, the blog idea was just a suggestion as to how better technology could give him the ability to do something on his own, rather than being completely dependent on others, and that this would probably be a boost to his self-esteem. Yes, of course, it's not "okay" that anyone is in this kind of situation, and it doesn't fundamentally alter the point at hand about the right to decide the manner of one's passing, but at least having some degree of control over one's own life is better than being absolutely stranded.
It's great to hear that they've managed to arrange that, Fergus, and I hope it helps that family out with the challenges they continue to face.
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This is a desperate situation, similar to that in "The Sea Inside" (Spanish film). In the US the Death with Dignity Act (Oregon and Washington states only) requires that the patient be terminally ill (six months life expectancy) and able to take the lethal medicine by mouth without assistance, hence is not applicable in such a case. But it is legal to refuse medical treatment and to refuse food and water. The ending is not as difficult as people might think, and there is research to support that finding. The patient can request palliative care and sedation.
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Here in New Zealand the euthanasia debate has reignited with a terminally-ill doctor submitting a letter to the New Zealand Doctor magazine, and republished in the NZ Herald on the 7th July: http://www.nzherald.co.nz/health/news/article.cfm?c_id=204&objectid=10660243
These situations are easy to empathise with; I hope a solution can be met quickly to end Fergus' isolation and suffering.
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It must be an awful experience for anyone living life to the full when suddenly this is taken away through something like a stroke and they end up restricted by their handicap like this for the rest of their life.
If it were to happen to me I almost certainly wouldn’t want to live in this state knowing all of what I used to be able to do has been taken away from me and there was no light at the end of the tunnel.
This is as important as others who suffer excruciating pain and discomfort to be released from this ‘trap’ since death is a form of ‘freedom’ from all this suffering as a last resort.
It was sad to see a couple of friends and relations who have been in pain and discomfort pass away but knowing they were no longer in pain comforted our feelings as we knew they were finally resting in peace and free from what they were experiencing.
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The poor man should have the choice in what to do with his own life.
It is unfair to expect someone to live in such a condition.
If you cannot survive under natural conditions, you should be allowed to choose to end your life.
This is a rule which is a breach of a persons right to die.
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Even here in the United States we have strict laws regarding physician assisted suicide. These rules are getting a change in a couple of states which do permit PAS under very strict circumstances. It must be a living hell to be trapped in a body and lose all ability to care for oneself. You can be sure that those who oppose PAS never had any experience with this condition. We have a right to self determination and no duty to suffer such a horror. The worry is that if we allow PAS for locked in syndrom and ALS will we then allow it for depression or other illnesses like that. I think we can deal with that as an issue. What we cannot do is deprive people who suffer like the gentleman in the story a welcome end to their suffering.
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Free societies are founded upon the idea of "free will." In a free society, each adult is an independent human being with a right to self-determination--not a "pet" or a "unit" of merchandise owned by someone or something else. Adults are not considered "incompetent" merely because they disagree with us, but must be found (by credible authorities) to demonstrate their alleged inadequacies across most or all areas of their lives. Assuming responsibilities that are not rightfully ours and/or abdicating responsibility for our choices and the consequences of our own actions are but two side of one coin. It is a coin that has been in circulation since the time of Rome, and is commonly called "Tyranny." Tyranny starts circulating through a society as small change, but in the end it controls every market.
Forcing fundamental life choices on others doesn't make us "enlightened" or "good"; it merely indicates the degree to which we (individually and collectively) seek to control other people's lives, while letting them suffer the consequences of our actions. It is either an act of monumental moral cowardice or of Machiavellian purpose. In either case, it reveals the degree to which we are willing to become tyrants to get our way, and deserves our most careful scrutiny. We are each responsible for our society's laws, and for the consequences they visit upon other people. Where the laws are Machiavellian we have a simple choice: personally see to it that they are struck from the books or continue onwards into that darkness of the soul from which have sprung, eventually, nearly all of humanity's atrocities.
In a free society, so long as those in question are competent adults, individuals retain the right to choose what happens to their own bodies. Where their choices may endanger others (for instance, people who refuse to be inoculated against contagions), the community has the right to enforce a quarantine (or similar restriction) until the threat has passed -- but it should never assume the right to use your body as if it was community property. When we force people to accept unwanted surgeries and implants, or to perpetuate a life that has become intolerable, we leave the moral high ground and enter a Shadowland from which few modern societies have emerged unscathed.
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Postscript: Of course, this assumes that we are actually living in free societies...
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I am a 78 year old trained nurse, and working in Nursing Homes I have seen a lot of suffering. I have followed discussions in different countries and have
only one conclusion. Every person must have the RIGHT to decide for themselves.
If one is not allowed to be helped (when one is helpless to act for ones self),
then it forces people to take their own lives maybe long before they really feel that it is necessary. In Norway the Politicians and Medical Leaders also talk about the patient not wanting to be a burden on others etc.
THERE ARE TWO SIDES TO NOT WANTING TO BE A BURDEN. 1. Not wanting to burden others. 2. One has LOST the ability to look after one self. This gives a deep, deep sense of LOSS & HOPELESSNESS. I would hate it, and I under such circumstances would hate everyone who forces me to stay alive against my will.
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M Burgen, very good reasoning, I cannot fail to agree. This about applying true Kantian respect to other wishes, although I'm not sure Emmanuel Kant would be happy about this application. The crux of the matter comes down to the common assumption that someone who wants death must be mad. This spawns in our society from our fear of death. Well if we delve a little deeper and put ourselves into the situation, which we can never truly do without actually being there. And as such we should not restrict the freedoms of a small section of society simply due to our lack of understanding and fear. Oh but yes baby jesus says its wrong, so better not actually let them have their "freedom".
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Without the advance of science, this poor man would not have survived and this discussion would not happen.
In this respect surely it is a case of a step too far for science.
A torturer is extremely skilled. They inflict suffering without allowing their victim to die. That is what modern medicine is capable of doing with no harm actually intended.
If I decide that I have had enough of my life, I may decide to end it. I have the ability to do so. Others may believe it is a tragedy. It may not be to me. But I can make that choice and take appropriate action if I so wish.
If life is intolerable for Mr Nicklinson it is hardly for anyone else to tell him it is otherwise.
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What's wrong with being a burden to your family? Everyone is a burden in some way or other & a family's loving obligation is to assist & care for their disabled.
Western society might want to examine the message disabled folk are receiving which seems to be to hurry up & die.
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