Paralysed woman to ask high court to let her die

Patient is first in UK to ask a judge to allow ventilator to be switched off

Clare Dyer, legal correspondent
Wednesday March 6, 2002
The Guardian

A woman paralysed from the neck down and kept alive on a ventilator will today become the first patient in Britain to ask the high court to allow her ventilator to be switched off, so that she may die.

The woman, a former social care professional in her 40s, will make her plea from her hospital room where England's senior family judge, Dame Elizabeth Butler-Sloss, lawyers and doctors will gather this morning.

The three-day hearing will adjourn in the afternoon to the royal courts of justice in the Strand, central London, from where it will be relayed to the woman's hospital room by video link.

Neither the woman, who is single with no children, nor the hospital where she is being cared for can be identified. She has been kept alive in hospital since last April after she was paralysed when a blood vessel burst in her neck. She has asked her doctors to turn off the ventilator but they refuse, saying it would clash with their ethical principles.

Her lawyers cite the Human Rights Act in support of her case. They argue that article 8 of the European convention on human rights, the right to respect for private life, and article 3, the ban on inhuman and degrading treatment, require her wish to be granted.

Her case differs from those of Diane Pretty and Annie Lindsell, the motor neurone sufferers who took right-to-die cases to the high court, because ending their lives required active steps to kill them.

A ventilator counts as medical treatment which a patient who is capable of taking decisions may legally refuse. Indeed, doctors may not force treatment on a legally competent patient.

The case also differs from that of Hillsborough disaster victim Tony Bland and other patients in permanent vegetative states, who were incapable of deciding for themselves.

The woman in the latest case is intelligent and articulate, and a psychiatrist appearing on behalf of the official solicitor will tell the court that she is competent to make her own decisions.

The law says that patients who can weigh up the pros and cons of a particular treatment and understand its nature and effects are entitled to refuse it, however unreasonable or quixotic the decision may seem to others.

The appeal court has ruled that a pregnant woman is entitled to refuse a caesarean section even if the likely outcome is death for her or her baby.

Doctors treating the woman want her to go into a rehabilitation centre, where she would be given special aids to try to improve the quality of her life. Her physical condition, however, is permanent, with less than 1% prospect of any improvement.

Her doctors argue that she cannot take an informed decision before she has tried rehabilitation. Her solicitor, Richard Stein of the London law firm Leigh, Day & Co, said: "She says this isn't life and she doesn't want to live like this. It's her choice.

"She's not saying what other people should want in that situation. She's saying the person she is doesn't want to continue living with the limitations placed on her."

The doctors caring for her say they will refuse to switch off the ventilator personally, even if the court holds it to be lawful.

But a doctor in charge of an intensive treatment unit has offered to let her move there to end her life.

Mr Stein said: "My client is a very courageous woman. She has a very clear view about the unbearable quality of life she faces as a result of her illness and her wish to have treatment withdrawn.

"It is, of course, a very personal matter for her, although she has the support of family and friends.

"The central issue here is one of a patient's right to make choices about his or her own treatment.

"The hospital is acting unlawfully in continuing artificial ventilation without my client's consent and is denying her right to respect for private life under article 8 of the Human Rights Act."

Mr Stein added: "It is very sad that in such a difficult situation, where my client's views are so clear, that she has to turn to the courts in a last resort to have her wishes respected."