Medical Law - Assisted Suicide - Essay Example

Law Essay Inserts His/Her Inserts Grade Inserts (Day, Month, Year) Law essay Suicide is the act of a person killing himself after having time, support, facilities, drugs, or help from another person. The issue of suicide raises debate on different levels, which varies from ethical, religious, moral, spiritual, professional, political and legal that has a strong impact on the nursing workforce. Several attempts have been made to change the law and legalize the issue of assisted suicide in the UK. With the most current draft legislation proposed by Lord Joffe, rejected in the House of Lords in the year 20061. Ann Soubry notes, “You cant say to a doctor or a nurse, Kill this person but... you have a right to kill yourself”. The rules that we have about who we can’t prosecute allow things to happen but theres a good argument that we need to be a bit more honest about it.” The MP for Broxtowe told the Times: "I think its ridiculous and appalling that people have to go abroad to end their life instead of being able to end their life at home. The suicide Act 1961, s 1, abrogated the rule of law in that it was a criminal offence for a person to take away his/her life by suicide. However, the act of suicide is not a serious crime, but intending to commit it shows the mental intention of murder2. In England and Whales, assisted suicide is illegal, under the 1961 Suicide Act. It is unlawful to help someone to commit suicide. In Northern Ireland, similar provisions on suicide are in section 13 of the Criminal Justice Act (Northern Ireland) 19663. In Scotland, assisting or attempting to assist someone to commit suicide is a criminal offence although there are no specific rules relating to it. Application and interpretation of the present laws is in practice; these laws are clear in recently in high-profile cases in Whales and in England. This is evident in the case where the crown prosecution service (CPS) has not prosecuted anybody that has accompanied the one hundred UK citizens that have gone there to end their lives at the facilities run by the Swiss Assisted Suicide Organisation Dignitas. In December 2008, the Director of Public Prosecutions (DPP) for England and Wales, Keir Starmer QC, said that the parents of a 23-year-old rugby player Daniel James would not face any charges after assisting his death at the Zurich Dignitas facility. Daniel James who was a rugby player became paralytic following an accident in a rugby training ground. Keir Starmer said that even if there was satisfactory evidence that makes it possible for Juliet and Mark to face murder prosecution under the Act of Suicide 1961, he had a feeling that this would not be in the interest of the public to charge them. Up to this time, nobody faced prosecution for helping someone with suicide4. Possibility of the laws changing, In the previous years, several attempts to change the law in England and Wales have failed. In 2006, the Labour peer, Lord Joffe brought a bill in the House of Lords to support suicide, the bill lost by one hundred and forty eight to one hundred votes. Daniel Pretty, diagnosed with Motor Neurone Disease, resulted into a rampant public attention. Pretty was diagnosed with the disease in 1990, the malady grew rapidly so that by the moment she began legal action in 2001 she could hardly leave her wheel chair. She could hardly feed and move, she requested that her husband be given permission to help end her life without fear of prosecution. The case highlighted the important ethical and legal dilemmas in balancing the right of an individual to self-determination with the rights of others, especially other vulnerable people that require protection by the law. In an effort to change the DPP’s decision, Daniel Pretty took her case to the Divisional Court for Judicial Review, she then appealed it to the House of Lords and then finally to the European Court of Human Rights (ECHR). While making the judgement, the ECHR concluded, “It was against the [UK] law, which criminalise assisted suicide.” The law has the duty to safeguard life by making sure that the weak and the vulnerable are safe, especially those who are not in a position to take informed choices. This involves actions intended to end life or even attempts to assist in ending life. In 2008, the Prime Minister, Gordon Brown, claimed that he did not support a change in the law for England and Wales in a move to legalise assisted suicide. However, currently there may be further attempts by a private members bill to draft legislation in a bid to propose a new legal framework for assisted suicide. At the end of 2008, the Queen made a speech that the western government would introduce a Concern and Justice Bill for England and Wales. The Bill had proposals to modernise the law on assisted suicide so that it can fit internet use and published materials, literature or anything that can assist a person to commit suicide. Many strongly believe that this move will be used as an opportunity to change the 1961 suicide Act. 5 Past bills for England and Wales have incorporated a number of safeguards. For instance, a person to qualify for suicide must be determined to be terminally ill, be in a position of making a choice whether to end his life or not. The patient should also be suffering unbearably, a minimum waiting period of fifteen days would also be required and physicians should check the applicants and make sure that they meet all the required criteria. According to Margo MacDonald of the Independent Member of the Scottish Parliament (MSP), said that sick people should ask the doctors to terminate their under given situations. This is the second attempt by the MSP to pass new laws in Scotland on suicide in the past four years. This is a great move after the failing of the first attempt. The proposals for Scotland by Margo MacDonald include safeguards that were in the previous bills for England and Wales. In this bill, it is not conditional that a patient must be terminally ill. It also qualifies a person who might be suffering from a degenerative disease, or incapacitated. In her consultation document, she asks whether sixteen is an appropriate age for an individual to qualify for assisted suicide6. For this bill to become a law, it depends on the support that the bill will receive from other MSPs. This is because of the way the Scottish Parliament works since there is no surety that these proposals will at the end turn into draft legislation, be debated again in the Scottish parliament and then passed to become a law. End of life In the recent years, there have been significant advancement to end of life care; an example is the Preferred Priorities for Care Tool. According to mental capacity tool, it is clear that individuals are active, as far as possible in the decision-making process about their life or otherwise proved that they lack the requisite mental capacity. The National Council for Palliative Care published in 2008 outlined guidelines on the Mental Capacity Act for England and Wales giving advice and support for practitioners engaging with those who lack requisite mental capacity7. An August 2008 review by Audit Scotland concluded that, “good quality palliative care [was] not available for everyone who needs it, especially those with conditions other than cancer,” the needed improvement were in terms of support for families and patients, referrals, assessments, future planning and workforce development. In September 2008, the Audit Scotland report released a Living and dying well report, this was to ensure that there was an improvement in the quality and delivery of palliative care and end-of-life services. The move is primarily focusing at NHS Boards and entails five key areas- planning and delivery of care; assessment and review of needs; education, training and workforce development; communication, co-ordination and implementation. However, a proposal taken to place NHS Boards in Scotland under a statutory obligation in order to provide quality care to everybody according to their needs and come up with reporting arrangements so that the level of care provided remain under check. Arguments in favour of assisted suicide. In some countries, assisted suicide is legal. In Switzerland, lawyers and doctors must see anyone who wants to commit suicide so that they can endorse assistance with suicide. In the same country, euthanasia is illegal8. Netherlands came up with euthanasia legislation in the year 2002 that gave permission to sick people to take their lives willingly. Approximately three thousand five hundred deaths surface every year. Doctors who are the only people allowed turn down about two thirds of suicide cases In the same year, 2002, Belgium also legalised suicide. For one to qualify for it, he or she must be under unbearable and constant or physical pain caused by an incurable disease or a tragic accident. Oregon State in the United States of America was the first to legalise lethal prescriptions. In Oregon, doctors have no legal right to prescribe lethal drugs to patients, assisting them to commit suicide. Some arguments are there that if someone feels that his/her life is not worth living, he or she has a sentimental right to decide to either live or not. Article eight of the European Convention on Human Rights states that, every person has a right to decide about his own body. Some argue that the state should not deny any person the option of assisted dying. Although the European Court of Human Rights violates Article 8 where the state limits the length at which an individual may cause injury and harm himself/herself9. They also believe that if somebody has a right to live and a right to some other things, the same person has a right to make his/her own life choices, which include the choice to assisted suicide. Those who support assisted suicide feel that the government should allow the act in UK rather than endangering its citizen life by letting them to go and look for it in different countries that support them. Persons advocating for a change in the legal framework on aided suicide refer to variations that are there in the present clinical practices. In some incidents, doctors are allowed by law to stop giving medication to ill people; they can also direct end of resuscitate in the process of advocating for treatment to ease pain that may not aim to speed up death. People supporting this argument, insist that U.K legal system should be amended in order to make sure that patients are given the equal rights on their life’s as clinicians while at the same time giving protection to clinicians ready to help suicides in case asked to do that. 10 Many people consider the idea of willingly ending a patient’s life upon his or her request as going contrary to clinical or medical ethics. The point is that the intention of letting patients die quickly would be hard to reconcile with the beneficence along with the malfeasance principles of medical ethics. A patient has the right to take or refute any medical advice even if it is to their detriment. According to the nursing and Midwifery council (NMG), Nurses need to guard and assist the health of patients and customers11. This code further stipulates that nurses should also respect individual rights and those of their patients or customers in planning for their care. Nurses also do have a professional legal and moral duty of respecting a person’s right to choose. One of the important elements in the practice of nursing is that any health professional should not have any right or option of suggesting a course of action, which can cause harm to a patient. This is relatively factual if the mental, emotional and physical situation of patient puts them in a situation in which they cannot make a rational decision on assisted suicide. More to that, patients usually trust doctors or nurses by believing that the treatment or advice they get is always considered being in their interests. When a doctor or a nurse agrees to carry out a request to assist suicide, this carries with it an indication that such an action is the right thing to do for the patient as per the clinical situations12. Instead of clinically aiding suicide, better palliative care will negate the desire to request for assisted suicide. People who believe in this argument say that the target should be on palliative care of dying patients so that to ensure appropriate pain control and comfort of the sick people. All human beings require dignity maintained throughout their lifetime. People who are about to die should understand that society and professionals in the health sector are committed to ensuring their well-being. Therefore, it is morally wrong for the society to legislate laws based on the assumption that some individuals are better suited to die. This will thus undermine each fundamental principle relating to the sanctity of life. It is critical to establish a balance between a right to decide on what happens to a person’s life and the rights of other people. The RCN’s position. In 2005, RCN had a balanced debate on the issue concerning suicide. The members did not support Lord Joffe’s Assisted Dying for the terminally third Bill in Westminster. The bill did not give limit to physician assisted suicide but suggested a sustainable responsibility in assisting death by the nursing profession. Extensionally, the bill was meant to ensure that the issue of physician-assisted suicide is legalised but the RCN felt that voluntary euthanasia had been excluded hence making it difficult for doctors to exercise it. Under Article 8 of the ECHR on protection of private life comprises of person’s psychological and physical integrity. According to article eight, matters that may affect the physical integrity of a person has to reach a given level of severity. However, the court also insists that even minute interference with a person’s physical integrity may as well fall under the scope of article eight if they are not in line with the person’s will. Medical administration against the will of a patient or currying out medical treatment interferes with the right to private life. Therefore, in any democratic society it has to be justified basing on the law. 13. With reference in the case of Y. And F.V Turkey, the wife to the diseased had been arrested on suspicion of assisting and hiring a terrorist group to kill her husband. After a period of four day in custody, the doctors examined her and then took her to a gynaecologist who later curried a gynaecological examination against her will. In response to the claims, the government claimed that the examination was necessary to verify if she had been sexually harassed while in custody. The court indicated that there was no legal basis for carrying out the examination and found a violation of article eight. 14 In Glass versus the United Kingdom, the first applicant was a child with mental and physical disability. While under treatment in hospital, he was diagnosed of lung cancer. The staff and the hospital had a deep disagreement with the second applicant who was the mother of the first applicant about the kind of treatment that the child was supposed to receive which even resulted in physical violence. The mother of the first applicant strongly opposed the staff’s move to administer morphine fearing that it might cause death of her child. Despite this opposition from the second applicant, the doctors decided to administer it when the health of the first applicant started deteriorating alarmingly.15 In that case, the court stated that the move by the hospital staff in administering morphine to the first applicant had interfered with the right to private life. The court stated that there were enough legal bases; however, the European Court of Human Rights insisted that the hospital should have gone for a court order in regards to the measures taken in case the health of the first applicant was at hand. Since the hospital did not follow the right legal procedure, the court found that the administration of morphine was not necessary in a society that upholds democracy hence violating article eight ECHR. Medical treatment that goes against the wish of a person is interference with the right to private life. However, interference to private life can be justified in the interest of the person affected especially in the instance of health protection. In a case of Acumen versus Belgium, the European Court of Human Rights insisted that a Belgium law that required all children to go through an x-ray examination in order to prevent tuberculosis was not in line with article eight ECHR. The right to private life does not include the right to acquire assistance to end one’s life. In the case of Pretty against the United Kingdom, the applicant got paralysed after suffering from an incurable ailment. The applicant needed an opportunity to choose on when she should die. The physical condition of her life denied her opportunity to do so. Helping someone to commit suicide is illegal in the UK. Her husband had willingly agreed to help her in the situation that the authorities accepted that they would not prosecute him for assisting her wife with suicide. All her requests were turned down by all local powers16. According to the applicant, right to self-determination was inherent to article eight ECHR, which entails the right to decide when to end one’s own life. The court agreed that denying the applicant of the possibility to decide on when to end her life at the time of her own choice interfered with her right to private life. The court indicated that the ban on assisted suicide is to protect the lives of vulnerable people and thus responding to a passing social need. Therefore, the council clarified that article eights ECHR was not violated17. The European Convention on Human Rights came up with no right to assisted suicide despite contrary accusations by the legal team of Marie Flaming. The European Convention on Human Rights tackles the issue of assisted dying on a number of situations and further states that no state has an eligible right to legalise suicide. In the case Pretty versus the United Kingdom that took place in the year 2002 in which the Pretty claimed that there was a right to die under the Convention while the ECHR had a firm claim that nobody is entitled to assisted suicide. ECHR further insisted that member states should be in the frontline in protecting lives of those people who are at risk18. Stakeholders on the issues of assisted suicide, Both sides of the debate have many stakeholders, which include medical bodies and campaign groups. These groups include; Dignity in dying, Care not Killing, The British Medical Association, Royal College of Nursing, Not Dead Yet UK and many others. Dignity in Dying. Dignity in Dying changed its identity from Voluntary Euthanasia Society; the group felt that terminally adult people be given a chance on the kind of death they want. The group believed that everyone has a right to a dignified death and an opportunity to choose over where they want to die, who to present their death and the kind of treatment that they should receive. Not Dead yet UK. This is a group founded by Jane Campbell in the year 2006, Jane Campbell, an adviser and campaigner for disability reforms and in 2007; she became a life peer. This is a broad network of people with disabilities. They should do what the organisation states as “the legalised killing of disabled people”. The group advocates for equal rights for all citizens regardless of their physical and health conditions The commission on Assisted Dying. The Commission on Assisted Dying became functional in November 2010. The group assesses the situations under which assisted suicide is permitted. In January 2012, the commission published its final report claiming that the current legal system of assisted suicide is inadequate and incoherent. The commission then proposed that a new legal framework should replace the current legal framework. The person making the decision must be above the age of eighteen years and be suffering from a terminal illness. In Scotland, assisting suicide does not have a given statutory offence. Although those who are willing to assist suicide could land themselves into a more general offences like reckless endangerment, murder, assault, culpable homicide, breach of peace or other offences under the Misuse of Drugs Act 197119. In January 2010, Margo MacDonald MSP introduced a new bill End of Life Assistance (Scotland). The aim of the bill was to allow assisted suicide to people who wish to end their life20. The Scotland parliament turned against the principles of the bill, on1 December 2012 the Bill fell. Conclusion In Wales and England, it is illegal for a person to commit suicide. In Belgium, Netherlands and Switzerland, assisted suicide is not a criminal offence. This has forced many people from the United Kingdom to travel to those countries that allow assisted suicide with an aim of ending their lives. A technical and more complicated question arises of whether it is an offence for a person in Whales and England to assist another person who intends to commit suicide to travel to other countries where assisted suicide is legal. The Director of Public Prosecution outlined policies on assisted suicide; the policy give guidance on when an individual may land into trouble for committing this offence. Despite this, policy does not affect the law hence failing to create a real situation on the issue on assisted suicide. 21. Bibliography (LL. M.), E. W., The Right to Life and Conflicting Interests, (New York: Oxford University Press, 2010). Boyle, E., Human Rights and Scots Law (Wasington DC: Hart Publishing, 2002). Breen, K., Cordner, ,. S., and Th, C. John, Good Medical Practice: Professionalism, Ethics and Law, (New York: Cambridge University Press, 2010). Callender, S., Free Will and Responsibility: A Guide for Practitioners, (New York: Oxford University Press, 2010). Bond, M. and Europe, C., Parallelausg. U.d.T.: Le Conseil de LEurope Et Les Droits de Lhomme, (Paris: Council of Europe, 2010). Hunter, C. R and Cowan, S. (Eds.), Choice and Consent: Feminist Engagements With Law and Subjectivity, (New York: Routledge, 2007). Chopdar, C. and Burton, N., Get into UK Medical School For Dummies, (New York: John Wiley & Sons, 2012). Martin, D. and Friedman, Assisted Suicide, (New York: Raintree, 2012). Duffy, D. and Ryan, T., New Approaches to Preventing Suicide: A Manual for Practitioners (2, illustrated ed.), (Washington DC: Jessica Kingsley Publishers, 2004). Gibson, B., The Pocket A-Z of Criminal Justice, (Washington DC: Waterside Press, 2009). Johnstone, M. J., Bioethics: A Nursing Perspective (5 illustrated ed.), (New York: Elsevier Health Sciences, 2008). Jon, Y., The Right to Life and the Value of Life: Orientations in Law, Politics and Ethics (illustrated ed.), (Washington DC: Ashgate Publishing, Ltd., 2010). Keown, J. Euthanasia, Ethics and Public Policy: An Argument Against Legalisation (illustrated ed.), (New York: Cambridge University Press, 2002). Negri, S. Self-Determination, Dignity and End-of-Life Care: Regulating Advance Directives in International and Comparative Perspective, (S. Negri, Ed.) California: Martinus Nijhoff Publishers, 2012). Paterson, C. Assisted Suicide and Euthanasia: A Natural Law Ethics Approach, (Washington DC: Ashgate Publishing, Ltd., 2012). Roca, J. and Santolaya, P., Europe of Rights: A Compendium on the European Convention of Human Rights, (,. J. Roca, & P. Santolaya, Eds.), (New York: Martinus Nijhoff Publishers, 2012). Shakespeare, T. Disability Rights and Wrongs, (Canada: Taylor & Francis, 2006). Sharpe-Young, G., New Wave of American Heavy Metal, (illustrated, Ed.), (New York: Zonda Books Limited, 2012). Temperman, J., The Lautsi Papers: Multidisciplinary Reflections on Religious Symbols in the Public School Classroom, (Washington DC: Martinus Nijhoff Publishers, 2012). Walsh, L., Depression Care Across the Lifespan, (New York: John Wiley & Sons, 2009). Read More