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

BBC News Online, 9 Nov. 06, reported on the inquest in Norwich into the death of Mrs. Olive Nockels, aged 91, who died in the Norfolk and Norwich University Hospital in 2003.

“The barrister for Mrs. Nockels’ family, Christopher McNicholas, told BBC ‘Look East’ that consultant Dr. David Maisey said patients died of dehydration about two or three times a week. The hospital denies this was said. . . . 

“When the inquest opened in July 2006 he cross-examined Dr. Maisey, the consultant. “One of the questions that I asked of Dr. Maisey was ‘Doctor, how often do you see patients die of dehydration in your hospital?’, to which he replied “I see it happen all the time.’ I immediately followed up that question with ‘Well, doctor, how often does that happen?’ And his reply was ‘about two or three times a week.’

“This is disputed by Dr. Iain Brooksby, the medical director at the hospital, who said: ‘We are quite clear that Dr. Maisey said it was not unheard of for elderly patients to be suffering from dehydration and for that to be a contribution in a very small number of deaths, i.e. once a month.’ ”

Mrs. Nockels’ family claimed that she had pleaded for food and a cup of tea in the days leading up to her death. The coroner returned a verdict of Death from Natural Causes. A consultant pathologist and a gastro-enterologist had been refused leave to give evidence on the grounds that they belonged to the Catholic Doctors’ Guild.

Antonia Tully, in SPUC’s Pro-Life Times of March 07, describes the effect of the Mental Capacity Act on nursing.

“ ‘During the past couple of years, I’ve seen euthanasia snowballing on the ward I was in.’ These are the words of a nurse working in a stroke rehabilitation ward in our NHS hospital. ‘Many patients coming into the ward are left unable to swallow and often unable to talk, after the stroke. Letting patients die from lack of fluid and food is a common occurrence here.’ ”

Britain’s hospitals’ poor record of recovery from stroke is well-known.

Josephine Ocloo, in Health Matters issue 67, asked “How does the healthcare system respond when things go wrong?” She was writing about medical accidents, but her assessment sounds familiar to those who have lost a relative to deliberate policy.

“Despite widespread support for a no-fault compensation scheme among victims of harm and health care professionals, the NHS redress scheme that has recently received final assent in Parliament, is a wasted opportunity for real change. It covers only claims under £15,000 and applies only to hospital care. But its biggest flaw is that it continues to allow NHS bodies to act as both judge and jury when something goes wrong, rather than ensuring any investigation is carried out by an independent body.”

“The doctor cleared of misconduct in hastening the deaths of two terminally ill babies called yesterday for more debate on end-of-life decisions,’ The Times reported on 12 July 07. “Michael Munro emerged with his reputation untarnished after a ruling by the General Medical Council that he had not acted inappropriately and that his fitness to practise was not impaired.”

Dr. Munro, 41, had admitted injecting two premature babies with a large amount of pancuronium, with the support of the babies’ parents, who had already taken the decision to withdraw breathing tubes from them.

Dr. Mary Knowles, chair of the Doctors’ Federation’s British Section, said in a statement issued on 11 July 07:

“It is distressing to read that the General Medical Council has cleared Dr. Michael Munro of wrongdoing. It is reported that he had given large doses of muscle relaxant to two seriously ill babies ‘to allow them to die peacefully’.

“In fact , such treatment leads to slow suffocation.”

Baroness Finlay of Llandaff, speaking in the House of Lords in the debate on Law Reform: Murder, said among other worthwhile remarks:

“It is worth noting, as was highlighted in the report, the sex difference in suicide pacts and consensual killings which usually involve male carers killing their spouses. That raises some very important societal issues around caring for those who are vulnerable. The threshold of exhaustion needs to be assessed differently for male carers, and yet health services are predominantly staffed by women, and it is women who are undertaking assessments with a view to respite care or enhanced support. It may be that we are not appropriate to assess male carers. . .”

“I remind noble Lords that Dr. Cox, whose actions were published as a mercy killing, was convicted of attempted murder. He was seriously admonished by the General Medical Council for failing to take advice from colleagues who knew far more about pain control and would have been able to offer constructive clinical advice in how to relieve the overwhelming distress of the patient. ...”

Disability Now reported in December 2006 that “Disability activists said they were ‘shocked and deeply disturbed’ after doctors suggested some disabled babies might be better off if killed at birth. The comments were made as part of a consultation by the Nuffield Council on Bioethics* on prolonging life in fetuses and newborn babies.

“In its submission** the Royal College of Obstetricians called on the Nuffield working party to ‘think more radically’ about a number of issues, “including ‘active euthanasia’ as a ‘means of widening the management options available to the sickest of newborns’.

“The submission cited euthanasia of babies with severe spina bifida as an example that could be discussed. It also called for a discussion on the costs of bringing up a severely disabled child.

“The Disability Rights Commission said it would ‘vehemently oppose’ a move towards euthanasia.

“The Nuffield report concluded that active ending of life of newborn babies should not be allowed, no matter how serious their condition.”

Bill Albert, a member of the United Kingdom Disabled People’s Council, said “The Royal College seems to be stuck in some other century. The barbarity of their suggestions. . . it is worrying stuff.”

*Critical Care Decisions in Fetal and Neonatal Medicine Ethical Issues: for a copy, tel. 020 7682 9619 or visit www.nuffieldbioethics.org

** www.rcog.org.uk

“A terminally ill woman fighting for the right to die yesterday dropped her legal battle after agreeing to try more treatment,” the Daily Mail reported on 19 Apr 07.

Mrs. Taylor, aged 30, who has Eis#enmenger’s Disease and Kippel-Fiel syndrome, had demanded that doctors should put her into a coma, and then let her die from lack of fluid. Under the Mental Capacity Act, doctors are legally obliged to obey an advance directive to this effect when patients can no longer communicate. Eisenmenger’s is not in fact a terminal illness. Disability Now reported in May 2007 that Baroness Campbell, from the anti-euthanasia campaigning group Not Dead Yet, welcomed Mrs. Taylor’s decision. She said she empathised with her situation, but did not agree with her request for help to end her life. She added, “We firmly believe that with the right support and pain relief, it can be avoided.’”

Doctors yesterday vowed to face prison rather than obey new ‘backdoor euthanasia’ laws that would force them to let their patients die.” (Daily Mail, 31 March 07). “They said they would ignore the Mental Capacity Act which comes into force tomorrow. The Act allows patients to instruct doctors that they wish to refuse treatment if their condition worsens. . . Those – including nurses – refusing to obey the instructions wold be open to prosecution for assault.” The Catholic Sentinel earlier reported: “Dr. Peter Saunders … says he’s concerned about patients who will make advance decisions to have food and fluids taken away without knowing the facts. . . 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’ ” (12 July 2006). Lasting powers of attorney, another part of the Act, could give relatives the power to refuse treatment, including food and fluid, to helpless patients.

The Daily Mail continued: “Peter Saunders, of the Christian Medical Fellowship, which represents 4,500 medics, said: ‘I know a number of doctors who will not stand by and allow their patients to die and who will risk criminal prosecution.’

“Philip Howard, a London gastroenterology consultant, said that he would not withdraw nutrition and hydration, even when it was specified in an advance decision. ‘No patient should die as a result of dehydration and no patient should be alowed to die in a state of unrelieved thirst,’ he insisted.

“Consultant geriatric psychiatrist Adrian Treloar said ‘If I am asked, will I kill a patient under the Mental Capacity Act? The answer is “no”.’”

The new UN Convention on the Rights of Persons with Disabilities should give these doctors some support. It was passed by the General Assembly on 13 December 06 and signed by the British Government in March 2007, but is not yet ratified. Article 25(f) lays down that States which are Parties to the Convention must “Prevent discriminatory denial of health care or health services or food and fluids on the basis of disability.”

The Joint Parliamentary Committee appointed from the Lords and Commons to consider the Government’s Bill was agreed on one thing at least: they did not like the look of the proposed Regulatory Authority for Tissue and Embryos (RATE), which was to replace the present Human Fertilisation and Embryo Authority (HFEA) and the Human Tissue Authority (HTA).

“We have found the evidence against establishing RATE overwhelming. . .” (Volume I Report, HL Paper 169-I, HC Paper 630-I).

The Committee recommended that the creation of inter-species embryos should only be authorised by a free vote in Parliament.