Withdrawing life sustaining treatment and euthanasia debate

• Published in: BMJ Vol. 323; no. 7323; pp. 1248 - 1249
• Main Authors: Woodcock, Tom, Biegler, Paul, McIntosh, Neil, Bell, M. D. D., Waite, Alasdair
• Format: Journal Article
• Language: English
• Published: London British Medical Journal Publishing Group 24.11.2001; British Medical Association; BMJ Publishing Group LTD
• Subjects: Analgesics; Death; Double effect; Duty of care; Ethical behavior; Ethics; Euthanasia; Letters; Life support measures; Lifesaving; Medical ethics; Medical practice; Neuromuscular blockade; Paralysis; Sedatives; Ventilation; Ventilators; Working groups; England
• ISSN: 0959-8138; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.323.7323.1248

EDITOR-Street and Henderson invite debate about an accepted medical practice (withdrawing life sustaining treatment under the influence of paralysing agents) that is approved by an authoritative ethical advisory committee and yet is of questionable legality. 1 It should be no surprise that a course of action that is ethically justifiable may be illegal, for the law of England on care at the end of life is both morally and intellectually misshapen. 2 In their commentary Inwald and Vandyck submit that the advice of the ethical committee is not compatible with the common law of England, and that to cause respiratory muscle paralysis in a patient without providing ventilatory support is a form of euthanasia. Given that patients given curare ought normally to be sedated or anaesthetised during pharmacological paralysis, this alleged suffering cannot be given much weight. [...]Lord Goff specifically rejected the compassionate avoidance of lingering as a defence against mercy killing. 2 Although we can construct a strong case for the moral acceptability of euthanasia in such circumstances, it is unlikely that a court could be persuaded that the practice is legal according to England's current law.