Conference: ‘A Right to Die?’ – Socio-legal perspectives at Keele University

6 March 2017

18th July 2017

School of Law, Keele University

Register here

Programme

10.00 Registration & Coffee

10.30 Welcome from Professor Alison Brammer, Head of Keele Law School

10:35 Introduction by Chair, Dr Sue Westwood

10.40 Keynote speaker: Professor Penney Lewis, Dickson Poon School of Law, King’s College London (‘Assisted Dying and Legal Change’)

11.10 Q&A

11.20 – 12.30 Panel 1: Assisted Dying & Euthanasia – Current Debates. Chair: Dr Anthony Wrigley

Speaker (1) Dr Iain Brassington, University of Manchester (‘Overview of Debates’)

Speaker (2) Professor Richard Huxtable, University of Bristol (‘Euthanasia, Ethics and the Law’)

Speaker (3) Professor Alison Brammer, Keele University (‘Safeguarding Issues’)

12.20 Q&A

12.30 – 1.15 Lunch

1.15 – 2.40 Panel 2: Assisted Dying & Euthanasia – Views. Chair: Professor Marie-Andre Jacob

Speaker (1) Professor Clare Wilkinson, Bangor University (‘Why do we want the right to die?)

Speaker (2) Dr Glenys Caswell, University of Nottingham (‘Agency, death and dying in the UK’)

Speaker (3) Davina Hehir, Director of Legal Strategy and Policy, Dignity in Dying (‘Choice, control and access to services at the end of life: Advocating for the right to die’)

2.30 Q&A

2.40 – 3.00 Tea Break

3.00 – 4.10 Panel 3: Assisted Dying & Euthanasia – Subjectivities Chair: Dr Tsachi Keren-Perez

Speaker (1) Professor Celia Kitzinger, University of York (‘Court applications for withdrawal of artificial nutrition and hydration from patients in a permanent vegetative state: Family experiences’)

Speaker (2) Dr Sue Westwood, Keele University (‘Older lesbians, gay men and the “right to die” debate’)

Speaker (3) Professor Sue Read & Dr Sotirios Santatzoglou, Keele University (‘Exploring hospice care from the perspectives of people living with multiple sclerosis: An exploratory case study’)

4.00 Q&A

4.10 – 4.15 Closing comments (Chair)

4.15 Close

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TV: BBC Panorama on communicating with patients suffering from disorders of consciousness

13 November 2012

BBC1, Tuesday 13 November 2012, 22.35-23.35 and available after broadcast via the iPlayer

From the programme’s website: “In a world exclusive, Panorama follows a group of severely brain injured patients and reveals the revolutionary efforts made to help them communicate with their families and the outside world.

Never before filmed, this Panorama Special spent more than a year with a group of vegetative patients in Britain and Canada.

They witness the moment when a patient regarded as vegetative for more than a decade is able to answer a series of questions whilst inside a brain scanner.

The findings have profound implications for the patients and their families, as well as ethical consequences for scientists and medical staff.”

In an earlier post (now updated), I looked at the law governing the withdrawal of artificial nutrition and hydration from patients in vegetative states and the implications of evidence from imaging studies that some of these patients have been misdiagnosed.


Radio: decision-making for an unconscious pregnant woman

14 July 2011

BBC Radio 4, Inside the Ethics Committee, Thursday 14 July 21.00-21.45, available indefinitely on the iPlayer

From the programme’s page:

Anne is brought into Accident and Emergency unconscious, having suffered a cardiac arrest. She is thirty five years old and pregnant.

Within hours of Anne’s admission to intensive care, she has another cardiac arrest and starts to have seizures. On several occasions over the next few days, the medical team think they might lose her. But each time she survives.

As Anne’s life hangs in the balance, how much should her pregnancy influence the decisions the medical team need to make about Anne?

THE PANEL

Dr Andrew Hartle, Consultant Anaesthetist at Imperial College Healthcare NHS Trust and a member of its Clinical Ethics Committee

Rosamund Scott, Professor of Medical Law and Ethics at the Centre of Medical Law and Ethics, Kings College London

Deborah Bowman, Senior Lecturer in Ethics and Law at St George’s University in London


Radio: withdrawal of treatment from patients in vegetative states

19 June 2011

BBC Radio 4, Tue 21 Jun 2011, 20:00-20:40, repeated on Sun 26 Jun 2011, 17:00-17:40, available after broadcast via the iPlayer

From the programme website: “A review into the care of patients in vegetative or low awareness states has been launched by the Royal College of Physicians. There are thought to be as many as 5000 such people in the UK. The working party will look at concerns that assessment and diagnosis of patients is not consistent across the country and will ask whether the cost of long term care is affordable to the NHS. Ann Alexander examines calls for a reform of the process to end the life of such patients where their families believe their loved one would no longer wish to be alive. The programme reveals how some hospitals appear unaware of the law and hears how the process can be lengthy and costly, putting families under further strain.”


TV: Between life and death

19 July 2010

Available on iPlayer until 26th July 2010

“Provocative documentary following the doctors who can now interrupt, and even reverse, the process of death. Filmed over six months in the country’s leading brain injury unit (Addenbooke’s Hospital, Cambridge), it follows the journey of a man who, by only moving his eyes, is eventually asked if he wants to live or die. Two other families are also plunged into the most ethically difficult decision in modern medicine.”

There is more on the programme at its site, including a blogpost by the head of the brain injury unit.


Comment: the law governing the withdrawal of artificial nutrition and hydration from patients in a permanent vegetative state

4 February 2010

New medical evidence regarding functional magnetic resonance imaging (fMRI) of patients diagnosed in vegetative states is in the news. The relevant article is Monti, Martin M., Vanhaudenhuyse, Audrey, et al. Willful Modulation of Brain Activity in Disorders of Consciousness N Engl J Med 2010 0: NEJMoa090537. [Addendum on 13 November 2012: newer evidence will be discussed in tonight’s Panorama programme showing that a patient previously thought to be in a vegetative state was able to provide information about his condition to researchers.]

English law on the withdrawal of artificial nutrition and hydration from patients diagnosed in a permanent vegetative state is governed by the decision of the House of Lords in Airedale NHS Trust v. Bland [1993] A.C. 789. Anthony Bland was in a persistent vegetative state (PVS) following the Hillsborough disaster. His family and medical team agreed that it was in his best interests to withdraw artificial nutrition and hydration (ANH). A declaration that such withdrawal would be lawful was sought from the courts. The House of Lords decided that although the intention of the doctor would be to bring about Bland’s death, the proposed withdrawal would be lawful as it constituted an omission rather than an act. The doctor’s duty did not require the provision of treatment that was not in the patient’s best interests.

In Bland, Lord Goff held that as a matter of practice, judicial approval should be sought in all PVS cases in which the patient’s medical team believe it is in her best interests for ANH to be withdrawn. The practice of obtaining judicial approval in all PVS cases has been formalised, first by the Official Solicitor’s successive Practice Directions, and more recently by the Code of Practice issued under the Mental Capacity Act 2005 (MCA) which assumes that the existing common law rule will continue despite the Act’s silence on this point. It will therefore continue to be the case that even when a patient-appointed donee of a lasting power of attorney consents to the withdrawal of ANH from a PVS patient, the approval of the Court of Protection will be sought prior to the implementation of the decision. (Mental Capacity Act 2005 Code of Practice [6.18], [8.18], [8.19], subsequently confirmed by Court of Protection Practice Direction 9E on serious medical treatment). This practice of seeking judicial approval in PVS cases has not been extended to other cases in which a decision is made to withdraw life-sustaining treatment, including ANH (in the dying phase) and ventilation. Although some such cases have come to court, most do not.

What is it that is special about PVS cases? Absent any judicial attempt to rationalise the special treatment of such cases, one can only speculate as to whether the rule requiring judicial approval in such cases reflects particular concern or is simply the result of historical accident. When ANH is withdrawn in a palliative care setting at the very end of life on the basis of the patient’s best interests, judicial involvement is not required. PVS patients, though, are not obviously dying and could live for many years longer if ANH were continued.

(adapted and updated from Penney Lewis, ‘Withdrawal of Treatment from a Patient in a Permanent Vegetative State: Judicial Involvement and Innovative ‘Treatment’’, Medical Law Review, Vol. 15, 2007, pp.392-399)