British Section of the World Federation of Doctors Who Respect Human Life

Judgment in Strasbourg, 9th March 2004

Para 70: ..."The Court notes that the second applicant... as mother of the first applicant - a severely handicapped child - acted as the latter's legal proxy. In that capacity, the second applicant had the authority to act on his behalf and to defend his interests, including in the area of medical treatment... It is clear that when confronted with the reality of the administration of diamorphine to the first applicant, the second applicant expressed her firm opposition to this form of treatment. These objections were overridden, including in the face of her continuing opposition. It considers that the decision to impose treatment gave rise to an interference with the first applicant's right to respect for his private life, and in particular his right to physical integrity..."

Para 81: "..."The Court is not persuaded that an emergency High Court application could not have been made by the Trust when it became clear that the second applicant was firmly opposed to the administration of a diamorphine... However, the doctors and officials used the limited time available to them in order to try to impose their views ... It observes in this connection that the Trust was able to secure the presence of a police officer to oversee the negotiations with the second applicant. Para 82: The doctors and the Trust... should not have engaged in rather insensitive attempts to overcome her opposition."

Para 83: "The Court considers that . . . the decision of the authorities to override the second applicant's objection to the proposed treatment in the absence of authorization by a court, resulted in a breach of Article 8 of the Convention."

This was a unanimous opinion. In addition, Judge Casadevall expressed his belief that the inclusion of a DNR notice in David Glass' case notes without his mother's knowledge "helps to understand better the qualms and distress experienced by the mother... and her manner of dealing with the situation during the disturbing and unbelievable fight that broke out between certain members of the family and the hospital doctors." Note: David Glass' two aunts and his uncle, who valued his life, were all sent to prison.

Wesley J. Smith's article in the Human Life Review, Fall 2003, begins:

"For more than ten years, conscious and unconscious cognitively disabled people who use feeding tubes have been legally dehydrated to death in the United States. This intentional life-ending act - clamping feeding tubes and denying all sustenance - has become so ubiquitous that, generally, little attention is paid. This public indifference was shattered by the Terri Schiavo litigation, an epic legal, political, and media struggle that pitted Terri's parents, Bob and Mary Schindler, against her quasi-estranged husband, Michael Schiavo. At stake was whether Terri would live, as fervently desired by her parents, or die by dehydration as demanded by her husband.

 The Schiavo case is not the first food and fluids case, but it is certainly the most notorious. Widespread revulsion over Terri's court-ordered dehydration sparked a grass-roots political campaign that culminated in the Florida legislature's rushed passage of 'Terri's Law,' which empowered the governor to intervene and prevent some categories of cognitively disabled people from being dehydrated. As soon as the bill became law, Governor Jeb Bush dramatically halted Terri's dehydration in its sixth day, setting off an international uproar. (As this is written the constitutionality of Terri's law - and hence the fate of Terri Schiavo - is being litigated...)."

Terri's Law has now been declared unconstitutional, and Judge Greer and Judge Baird have condemned her to death (30 April 04). Copies of Wesley Smith's examination of the whole issue are available from the Doctors' Federation.

"I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represents a natural means of preserving life, not a medical act," said Pope John Paul II at an International Congress in Rome on 20 Mar. 04. Likewise, "Considerations about 'the quality of life, often actually dictated by psychological, social and economic pressures, cannot take precedence over general principles" A human being cannot be a vegetable, however disabled he may be. "It is not possible to rule out a priori that the withdrawal of nutrition and hydration, as reported by authoritative studies, is the source of considerable suffering for the sick person, even if we can see only the reactions at the level of the autonomic nervous system, or of gestures. Modern clinical neurophysiology and neuro-imaging techniques, in fact, seem to point to the lasting quality in these patients of elementary forms of communication and analysis of stimuli."

The International Congress on "Life-Sustaining Treatments and Vegetative State: Scientific Advances and Ethical Dilemmas,." 17-20 March 2004, which the Pope was addressing, was attended on behalf of the Doctors' Federation by Dr. Jacqueline Laing, D.Phil., Senior Lecturer in Law at London Metropolitan University. In her report she says:

"Of particular relevance to the position of the United Kingdom was the lecture by Dr. Keith Andrews, Director of the Institute of Complex Neuro-Disability, London, U.K. It was he who demonstrated in an important article published in the B.M.J. in 1996 the high rate (over 40%) of misdiagnosis of PVS.

"In the course of the seminar entitled 'Practical Dilemmas of Treatment Decisions: Withholding or Withdrawing Treatment - from a Clinician's Point of View'. Dr. Andrews drew heavily upon the highly criticized decision of the UK.'s House of Lords in Airedale NHS Trust v. Bland 1993). 1 ALL ER 821. He described the business of removing nutrition and hydration from patients diagnosed in a PVS, applying the dubious reasoning in Bland that it would and could be in the best interests of non-consenting patients who are not dying at all to be deprived of sustenance.

"What was disturbing about the Bland decision and what attracted strenuous opposition from critics was that it marked an important shift in legal reasoning of the courts. Instead of considering the futility of the treatment, the burden of the treatment, the expense of treatment, the decision was for the first time considering the worthwhileness of the patient and the burdensomeness of the patient himself."

Responding to an announcement by the Minister for Constitutional Affairs, on 22nd April, that a revised Mental Incapacity Bill would be introduced before the summer recess, SPUC said "The adjustments to the Bill announced by Lord Filkin do not amount to any material lessening of the threats posed by this draft legislation," and were "cosmetic changes designed to make legalised euthanasia by omission respectable."

Mr. Robin Haig, a solicitor and chairman of SPUC, wrote in the Universe on 14 March 04: "The government has declared that euthanasia involves some positive action, and thus, by that definition, killing by omission (e.g. failing to feed someone) is deemed not to be euthanasia. The result is the same, however - a dead body."

"An investigation has been launched into the death of an 88-year old patient who allegedly went without food and drink for six days" (Eastbourne Herald, 2 Apr 04). Lillian Cook, of Anglesey Avenue, Hailsham, was admitted to the hospital with a minor stroke in 1998. Six days later` she was dead.

"Mrs. Cook was designated nil by mouth whilst tests were arranged to establish whether the stroke had affected her swallowing muscles - despite the fact that she had been managing to eat and talk normally."

"A great-grandmother of 91 was last night being given fluids again after her family won a court order forcing doctors to keep her alive," Jenny Hope reported in the Daily Mail, October 8th 2003. "Former school matron Olive Nockels had gone more than 48 hours without water, food and antibiotics after doctors decided she had no quality of life."

Mrs..Nockels' grandson, Chris West, said he was convinced the hospital wanted his grandmother to die "so she does not take up bed space." Sadly, the High Court later decided she could be given strong painkillers again, though her grandson said she was not in pain, and she died two days later. There will be an inquest.