The answer to a difficult life is not murder

I posted this at the Daily Mail Online yesterday – since when a judge has decided that the case can be heard in court. As the leader in the Telegraph commented, “momentous moral issues such as this must always be decided by Parliament, not the judiciary”.

No one listening to the wife of Tony Nicklinson this morning on the 8.10am interview on Radio 4 could fail to be moved by her concern for her husband. Tony has “locked-in syndrome” following a stroke in 2005, which means he is totally paralysed and but mentally sound. He communicates through blinking, a technique that was made famous by Jean-Dominique Bauby, the French editor of ELLE magazine who similarly suffered a stroke at the age of 43 which left him only able to move his left eye-lid.

Tony Nicklinson has launched a legal action that would mean he could ask a doctor to end his life and the doctor would not be prosecuted for murder. He is trying to get an assurance that the rarely used ‘common law defence of necessity’ could be used by any doctor who took the action to end Tony’s life. Tony doesn’t want to die yet but if there comes a time when he thinks his life has become unbearable he wants to know that he can ask to be killed. This goes beyond the assisted suicide for which ‘Dignitas’ has become famous, as Tony is too disabled to take part in ending his own life through, e.g. drinking a lethal cocktail.

The problem is that what he is asking for is a fundamental change in the law on murder. It would set a precedent and ‘He wanted me to end his life’ would become a legitimate plea. This is one of those hard cases which if acted upon would leave us with not just a bad law, but a vulnerable population. Any severely disabled person would be at risk of someone declaring that they had wanted to die, especially those who find it difficult to communicate. 

So what is to be done? Has Tony and others like him no choice but to be kept alive? I don’t think that this is the case. As long as you have the mental capacity to make a decision, you have the legal right to refuse treatment. People like Tony are at high risk of infections, further strokes and other life threatening complications. He could simply say that he doesn’t want to prolong his life, stop taking his pills (apart from the pain relief) and sign an ‘advance decision’, a legally binding document that sets out what treatment you do and don’t consent to. ‘Nature’ could then take it’s course. 

The trouble is that we haven’t had enough public discussion about medical intervention. Our ability to keep people alive has in many cases I think outpaced people’s desire to live. Only this weekend I heard about further ‘progress’ in finding a pill that will allow us to live for another few decades. Have any of these researchers asked the public if that’s what they want? I think the answer would be a resounding NO! We joke in health that dying is no longer an accepted outcome of treatment. However death is one of life’s certainties and we seriously do need to have more debate and information about what our choices can be without introducing any new law that would introduce fear, uncertainty and legalise murder.



About Julia Manning

Julia Manning is a social entrepreneur, writer, campaigner and commentator. She is based in London and is the founder and Chief Executive of 2020health, an independent, social enterprise Think Tank whose aim is to Make Health Personal. Through networking, technology, research, relationships and campaigning 2020health has influenced opinion and action in fields as diverse as bioethics, alcohol, emerging technologies, fraud, education, consumer technology and vaccination. Julia studied visual science at City University and became a member of the College of Optometrists in 1991. Her career has included being a visiting lecturer at City University, a visiting clinician at the Royal Free Hospital, working with south London Primary Care Trusts and as a Director of the UK Institute of Optometry. She specialised in diabetes (University of Warwick Certificate in Diabetic Care) and founded Julia Manning Eyecare in 2004, a home and prison visiting practice for people with mental and physical disabilities using the latest digital technology, which she sold to Healthcall (now part of Specsavers) in 2009. Experiences of working in the NHS, contributing to policy development, raising two children in the inner-city and standing in the General Election in Bristol in 2005 led to Julia forming 2020health at the end of 2006. Julia is a regular guest on TV and radio shows such as BBC News, ITV’s Daybreak/ GMB, Channel 5 News, BBC 1′s The Big Questions, BBC Radio, LBC and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week. She is mum to a rugby-mad son, a daughter passionate about Shakespeare, and wife of a comprehensive school assistant head-teacher. She loves gardening, ballet, Zimbabwe, her Westies Skye and Angus, is an honorary research associate at UCL and a Fellow of the RSA.
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