Debate. Physician-assisted suicide: Lord Joffe's Slippery Bill

Medical Law Review

Volumn 15, Issue 1, 2007, Pages 126-135

  Keown, John ^a  

^a GEORGETOWN UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; ASSISTED SUICIDE; HUMAN; INFORMED CONSENT; INTRACTABLE PAIN; LEGAL ASPECT; MEDICAL ETHICS; MEDICOLEGAL ASPECT; MENTAL CAPACITY; MENTAL STRESS; PSYCHOLOGICAL ASPECT; TERMINALLY ILL PATIENT; UNITED KINGDOM;

ETHICS, MEDICAL; GREAT BRITAIN; HUMANS; INFORMED CONSENT; LEGISLATION, MEDICAL; MENTAL COMPETENCY; PAIN, INTRACTABLE; STRESS, PSYCHOLOGICAL; SUICIDE, ASSISTED; TERMINALLY ILL;

EID: 33847795889     PISSN: 09670742     EISSN: 14643790     Source Type: Journal    
DOI: 10.1093/medlaw/fwl020     Document Type: Article

References (34)

1. Hereafter 'the Bill'. The Bill is available at http://www.publications.parliament.uk/pa/ld200506/ldbills/036/ 06036.i.html. The Second Reading debate is available at http://www.publications.parliament.uk/pa/ld199697/ldhansrd/pdvn/ lds06/text/60512-01.htm#60512-01_head2
2. Hereafter 'the Committee'. Report of the Select Committee on the Assisted Dying for the Terminally Ill Bill. H.L. Paper 86-I. ('The Report') The Report, together with its substantial volume of oral and written evidence (Paper 86-II) and its slighter volume of selected individual written evidence (Paper 86-III), is available at http://www.publications.parliament.uk/pa/ld/ldasdy.htm. References to the Report are either to paragraphs in Vol. I, or to paragraphs and question numbers in Vol. II.
3. See John Keown, Euthanasia, Ethics and Public Policy (Cambridge University Press 2002), ch. 15.
4. The Bill, Long title.
5. A copy of the previous Bill is contained in Appendix 4 to Vol. I of the Select Committee Report.
6. Royal College of Psychiatrists, 'Assisted Dying for the Terminally Ill Bill - Statement from the Royal College of Psychiatrists on Physician Assisted Suicide' (2006); http://www.rcpsych.ac.uk/pressparliament/ collegeresponses/physicianassistedsuicide.aspx
7. Ibid., 2.3.
8. Ibid., 3.
9. Para 269(c)(v).
10. See Keown, op. cit. n3,
11. supra, chs. 8-13; 15
12. Neil M. Gorsuch, The Future of Assisted Suicide and Euthanasia (Princeton University Press 2006), ch. 7.
13. Vol. II, p. 47, Q.70.
14. Vol. II, p. 58, Q.124.
15. Vol. II, p. 53, Q. 89.
16. During the second reading debate, however, he said that he no longer favoured widening the Bill. H.L., Parl. Deb., Vol. 681, col. 1188.
17. Clauses 1(a) and 13(1).
18. Vol. II, p. 56, Q. 109.
19. See Vol. II, p. 54, Q. 98.
20. Vol. II, p. 56, Q. 108.
21. T. Appleby, 'Suicide law falls short, activist says' Globe & Mail, 7 December 1994 (A10).
22. Gerrit K. Kimsma, 'Euthanasia Drugs in the Netherlands' in David C. Thomasma et al. (eds), Asking to Die: Inside the Dutch Debate about Euthanasia (Kluwer, 1998) 135 at 142-143 (see Keown, op. cit. n. 3, supra at 34).
23. Johanna H. Groenewoud et al., 'Clinical Problems with the Performance of Euthanasia and Physician-Assisted Suicide in the Netherlands' (2000) 342 New England Journal of Medicine 551 at 554-555 (see Keown, op. cit. n.3, supra, at 34-35).
24. Vol. II, p. 48, Q. 70.
25. Death with Dignity Act 127.825 s.3.03.
26. See above at n.10, supra.
27. Ibid.
28. At Vol. II, p. 53, Q. 86.
29. The Bill's definition of 'terminal illness' in clause 13(1) as one which inter alia 'cannot be reversed by treatment (although treatment may be successful in relieving symptoms temporarily)' would appear to have included terminal illnesses which would not, with treatment, result in death within six months. See Lord Joffe's testimony, Vol. II, p. 60, Q. 138.
30. A 'specialist in palliative care' in clause 2(2)( f ) was not defined by the Bill.
31. The Bill required (clause 13(1)) the consulting physician to be 'independent' of the attending physician which Lord Joffe defined as an absence of financial relationship. (Vol. II, p. 59, Q.134). There need be no such relationship between Dr Gray and Dr White (nor between either of them and any 'independent' psychologist at the clinic to whom Ethel might have been referred).
32. Under clause 8(1), a physician who complied with the terms of the Bill committed no offence. This protection appeared to extend even to a physician who was grossly negligent in, say, failing to spot the patient's incompetence. Under clause 8(3), a person present when a patient committed suicide committed no offence if present in reliance on information that the terms of the Bill had been satisfied.
33. For the views of the Royal College of Physicians and the Royal College of Nursing see http://www.rcplondon.ac.uk/news/news.asp?PR_id=310 and http://www.rcn.org.uk/news/display.php?ID=1255&area=Press, respectively.
34. For a full critique of the Bill and the Select Committee Report see John Keown, Considering Physician-Assisted Suicide (Carenotkilling Alliance, London, 2006), available at www.carenotkilling.org.