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PubMed1998

Death on camera.

Explore the source record for details and available documents.

Attitude to Death↗
PubMed1984

Dignity and cost-effectiveness: analysing the responsibility for decisions in medical ethics.

In the operation of a health care system, defining the limits of medical care is the joint responsibility of many parties including clinicians, patients, philosophers and politicians. It is suggested that changes in the potential for prolonging life make it necessary to give doctors guidance which may have to incorporate certain features of utilitarianism, individualism and patient-autonomy.

Aged↗
PubMed2000

Futility has no utility in resuscitation medicine.

"Futility" is a word which means the absence of benefit. It has been used to describe an absence of utility in resuscitation endeavours but it fails to do this. Futility does not consider the harms of resuscitation and we should consider the balance of benefit and harm that results from our resuscitation endeavours. If a resuscitation is futile then any harm that ensues will bring about an unfavourable benefit/harm balance. However, even if the endeavour is not futile, by any definition, the benefit/harm balance may still be unfavourable if the harms that ensue are great. It is unlikely that we will ever achieve a consensus definition of futility and certainly not one that is applicable to every patient undergoing resuscitation. In the meantime our use of the term "futile", in the mistaken belief that it tells us whether it is worth resuscitating or not, has no utility as it will never succeed in telling us this. Furthermore we risk causing offence by use of the term and we risk harming the patient's autonomy by using futility as an overriding force. Instead we should consider the utility of our endeavours, for which an assessment of the harms of resuscitation should be added to our considerations of its benefit. This balance of benefit and harm should then be evaluated as best it can be from the patient's perspective. The words futile and futility should be abandoned by resuscitationists.

Decision Making↗
PubMed2002

Comment on Re B (Adult: Refusal of Medical Treatment) [2002] 2 All England Reports 449.

The judgment handed down in the case of Ms B confirms the right of the competent patient to refuse medical treatment even if the result is death. The case does, however, raise some interesting legal points. The facility for conscientious objection by doctors has not previously been explicitly recognised in case law. More importantly perhaps is that the detailed inquiry by the court into Ms B's reasons for refusing treatment, apparently as a precondition for finding her competent, seems to contradict earlier case law where it has been asserted that competent patients can refuse treatment for no reason at all.

Adult↗
PubMed2002

The case of Ms B and the "right to die".

The High Court in England has ruled that doctors are acting illegally if they refuse to comply with a competent patient's request to switch off their ventilator even if the result would be death. If doctors feel unable to do this then they must arrange for the patient to be transferred to the care of a colleague who is prepared to comply with the request.

Adult↗
PubMed1983

Symposium 1: The Arthur case--a proposal for legislation.

Following the acquittal of Dr Leonard Arthur in the case of the Down's syndrome infant the co-authors of the first paper in this symposium prepared a draft bill on the treatment of chronically disabled infants which has since been informally commended by the Director of Public Prosecutions. A second contributor, a law student, also argues for legislation as being the most effective way for society to have its standards clarified and observed. In a final paper Dr Havard, Secretary of the British Medical Association, opposes legislation believing it would raise far more problems than it would resolve. The first article was originally published in the Law Society's Gazette.

Down Syndrome↗
PubMed1980

Moral and ethical dilemmas: seven years into the debate about human ambiguity.

Developments in modern medical technology force many questions upon the health professions and the public. To what extent should technology be used to extend life when doing so seems futile, perhaps brutal? Who should decide such questions? What options should be available? Conditions in which such questions arise are often chaotic because of the nature of illness and treatment and because many extremely important issues in life have been poorly deliberated by the health professions and the public. This essay is an attempt to clarify some of the issues.

Decision Making↗