Family refused permission to turn off life support

A judge has ruled that a 'minimally conscious' patient must be kept alive, in spite of opposition from the family. It's an important legal ruling; but does it make her life worth living?

It is a scenario any family would dread having to face. Eight years after a sudden illness left her 'minimally conscious', the relatives of a 52-year-old woman known only as 'M' requested that she be allowed to die. This week, a high court judge refused their wish.

During her life, the family argued, M had made clear that she would rather die than live in a semi-vegetative state. But with no written evidence of her wishes, such claims could not be taken into account. The judge ruled that because M's life still included moments of pleasure, it was in her best interests that it continue.

The case sets an important precedent. In the UK, it is legal to withdraw the life support of patients who show no signs of consciousness, and are classified as being in a 'persistent vegetative state'. But M has occasional, limited, moments of awareness.

Her carers say she attempts to communicate, responds to touch, and, poignantly, weeps on hearing Elvis Presley songs. For Mr Justice Baker, the judge, this showed M had 'some positive experiences' and should be kept on life support: in cases of doubt, it seems, the law has decided we should err on the side of life.

The decision is good news for those who see any move towards assisted suicide as a slippery slope; this case will not allow the families of people with similar levels of illness to cut their life support.

Some campaigners against changes to the law fear a culture in which even the early stages of degenerative conditions like Alzheimer's or Motor Neurone disease merit euthanasia.

Also, there have been patients like M who have recovered. Some, worryingly, turned out to have been conscious throughout their long ordeal, but suffering from locked-in syndrome: the individual was thinking and feeling as normal, but totally paralysed and unable to show reactions.

A life worth living?

So how do we define what our lives are worth? Most human existence has its share of terrible pain and mindless drudgery as well as joy. Arguably, even tiny instances of pleasure, or contentment, are gifts to be cherished – better than the unknown expanse of death, and worthwhile enough to fight for, regardless of how insignificant they may seem.

But for this family, M's life is not worth living. The things she enjoyed – skiing, or walking her pet Labrador – are now unavailable to her. Unable to enjoy even a cup of tea, they say, her life has been reduced to passively receiving everyday attentions: being showered, placed in a chair and returned to bed. A life devoid of any richness or interest is too bleak to continue – moments of pleasure cannot make up for it.

You Decide

  1. It is now possible to make a 'living will', which describes how you would like to be treated if in a vegetative, or minimally conscious state. How would you approach the dilemma for yourself?
  2. Can the worth of someone's life experience ever be objectively assessed?

Activities

  1. Write a two-part argument: the case for and against relaxing the law on euthanasia.
  2. Research the impact of laws which allow assisted dying in Switzerland and the Netherlands.

Some People Say...

“Anyone who can should be allowed to choose their own death.”

What do you think?

Q & A

How would M die, if the court had ruled in her family's favour?
M relies on feeding and hydration tubes – these would be removed, and she would gradually die. This is how patients in a persistent vegetative state currently die – 43 people have died in this way, with permission from courts.
But this isn't the same as assisted dying?
No. Assisted dying or assisted suicide is when an individual decides they want to die, but require help because of a physical disability, such as Motor Neurone disease. The ethical dilemmas are quite different, too. In cases like M's, the family must make the decision on behalf of the patient – in assisted suicide cases, the patient is making the decision, but others, relatives or doctors, are dragged into the legal issues because they have to help.

Word Watch

Precedent
In courts of law, a precedent is a legal decision made in one case, which then applies to cases that follow.
Euthanasia
The killing of a patient suffering from a terminal illness, usually to avoid prolonged and sustained suffering.
Locked-in syndrome
Being paralysed and unable to communicate, but maintaining consciousness, thought and perception. Because it is so difficult to diagnose, some patients have been 'locked in' for many years before doctors realise they are awake and aware.

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