In Secretary of State for the Home Department v. Robb, the court held that a refusal to accept life – prolonging treatment was not equivalent to the commission of suicide. In addition, compliance with a patient’s requests, in this regard, does not constitute assistance of abetment of suicide (Secretary of State for the Home Department v Robb). In R v Collins the court reinforced doubt, as to whether there was a right of self-determination to reject food and water. It questioned whether prisoners had the right to intentionally starve to death.
In that case, the defendant was serving a sentence for having participated in the Moors Murders incident. He was diagnosed as mentally ill and later shifted to a mental hospital (R v. Collins and Ashworth Hospital ex parte Brady). Although, doctors cannot assist in the suicide of patients who are not in complete PVS, they are permitted to cause death by omission. In practice, doctors do not assist competent patients to end their life; but assist such patients by omission. It was proposed by the House of Lords Select Committee to legalise intentional killings; at the request of the patients.
At the moment, intentional killings by omission are legal and do not require any request from the patient (Keown, Euthanasia, Ethics and Public Policy : An Argument Against Legalisation, 2002, P. 236). The Dutch euthanasia law was enacted in the year 2002. Gradually, the scope of its application is being extended beyond the guidelines. Initially, patients seeking euthanasia and assisted suicide had to be above 12 years of age, mentally competent to give their informed consent, and should make such requests voluntarily and repeatedly.
In addition, such patients must be undergoing unremitting and unbearable suffering, and there should be no alternate and reasonable solution to their suffering (Dutch euthanasia law exists to protect doctors, not patients , 2005). However, Dutch doctors had on several occasions, determined that death was inevitable and appropriate for patients who had failed to fulfil all these legal requirements. The law requires doctors to be circumspect, while carrying out euthanasia.
In other words, the exercise of due care connotes that their actions must be as per the accepted standards of the medical profession. This requirement made euthanasia and assisted suicide legal (Dutch euthanasia law exists to protect doctors, not patients , 2005). Assisted suicide is legal in the Netherlands, provided it is rational. In one particular case, the Dutch Supreme Court had endorsed assisted suicide by a psychiatrist. In that case, a distraught woman had frenetically attempted to end her life, since all of her children were dead.
Medical practitioners encounter similar situations in their profession. According to Margaret Pabst Battin, of the University of Utah, suicide is a rational choice for patients to end their pain and suffering in terminal illnesses (Smith, 2007). The law does not provide unqualified assent to people who wish to end their life, in order to circumvent the pain and suffering caused by terminal illnesses. As such, instances of euthanasia and physician assisted suicide do occur.
At the moment, the courts have recognised personal autonomy to the extent that a competent adult patient can refuse treatment or choose some alternate treatment; even if the outcome were to be death (Griffiths, 1999).
List of References
Airedale NHS Trust v Bland, (1993) 1 All ER 821 HL. Dutch euthanasia law exists to protect doctors, not patients . (2005). Retrieved January 7, 2009, from http://www. internationaltaskforce. org/iua32. htm Dyer, C. (March 20, 2004). Hospital breached boy’s human rights by treating him against his mother’s wishes. British Medical Journal , Vol. 328, P. 661.