Society’s ethical dilemma

The high court denied a man suffering from locked-in syndrome the right to die, bringing back to the fore the euthanasia debate

The tragic case of Tony Nicklinson has thrust the ethical dilemma of euthanasia back into the limelight. Nicklinson, 58, died from natural causes last week after losing a High Court battle to be allowed assisted suicide. A second man known as Martin, 47, also lost, and is likely to raise a legal challenge.

Pressured decisions

The case has prompted heated debate among the media, church and medical professions – as well as the public (see vox pop, p13). Church leaders supported the ruling, with Rev Dr Brendan McCarthy, the Archbishop of Canterbury’s advisor on medical ethics, writing in the Telegraph: “It is naive to think that if some form of euthanasia were permitted, some individuals, vulnerable through age, illness or disability, would not be pressured into making a ‘voluntary’ decision to seek to have their lives ended.”

Communicating through blinks, Nicklinson accused the judges in the case of cowardice. But what exactly are an individual’s rights and duties in relation to euthanasia?

The law as it stands is opaque, perhaps deliberately so. Euthanasia is against the law, and classed as a criminal act. There is distinction between passive and active euthanasia. Passive euthanasia, when treatment that the patient has not consented to is ended, has been allowed to pass without prosecution, as under the 1993 Bland case. Active euthanasia, when treatment is administered with the intention of ending the patient’s life, has led to prosecutions such as that of Dr Arthur in 1985. Dr Arthur, who administered a sedative to a severely-ill newborn baby, was acquitted.

Euthanasia is legal elsewhere in Europe, notably Switzerland, home of the Dignitas clinic for assisted death for those with terminal illnesses and severe physical and mental illnesses. About 180 British citizens are believed to have travelled to Dignitas to be helped to die. Martin, the second appellant in the Nicklinson case, wishes to travel to Dignitas.

Prosecution protection

However under government guidance, issued after the case of MS sufferer Debbie Purdy in 2010, only friends and relatives of the victim are likely to be protected from prosecution if they aid travel to Switzerland.

Professionals, for example a doctor, would be liable to face prosecution. Martin, whose wife is unwilling to help ?him to die, sought to overturn this ?guidance, but failed.

Individuals do have the option to write living wills, which set out their wishes regarding healthcare if they became seriously ill or incapacitated ?and unable to communicate. These advance decisions only apply to the right to refuse treatments, ?and not to be actively helped to die.

The law surrounding euthanasia is expected to be subject to further judicial and parliamentary scrutiny following the public scrutiny prompted by Nicklinson’s life and death.