'It Could Take Up to 2 Weeks Before Someone Succumbs to Dehydration' - Activist

The UK's Supreme Court has ruled that legal permission is no longer necessary to withdraw treatment from patients in a permanent vegetative state. According to the ruling, family and doctors can now agree to remove food and liquid to allow such patients to die without making additional court applications.
Sputnik

Sputnik spoke about this with Alistair Thompson, a spokesman for the anti-assisted dying group, Care Not Killing Alliance.

Sputnik: How would you assess the key Supreme Court decision?

Alistair Thompson: Well, we are concerned and disappointed at the ruling because we feel it removes an important safeguard. Most patients who are in PVS, which is a permanent vegetative state, or MCS, a minimally conscious state, they are not cared for in hospitals but specialist nursing homes and we feel that the expertise of doctors who can make a very important and decisive diagnosis of these patients — removing that safeguard could mean that some people die who do not need to.

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Sputnik: Critics have already said that this decision would remove a layer of protection for the most vulnerable, which may lead to abuse. Do you agree with that?

Alistair Thompson: I think that is correct. It may not be overt abuse, if I can describe it as such, it may be that people feel under huge amounts of pressure, either financial or care burdens, because these are very tragic cases and we're talking about people who are unlikely to ever make any significant improvement.

The worry is that because of this ruling, having a dispassionate judge, someone who can look at this very independently and scrutinize further the information and evidence from the doctors and from the family; some people may die who otherwise don't need to.

Sputnik: Relatives of such patients had to take their cases to the court of protection, but the process could take months or years. Will this decision help relatives of patients who think that their dearest ones won't be able to recover and therefore, their only solution is to let them go?

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Alistair Thompson: I think you're right and I think it's also important to say that, we're not arguing that the court of protection system is perfect: it takes too long [and] it can also be hugely expensive. But, it is an imperfect safeguard that prevents any abuse; since 1993, the Tony Bland case, which set the precedent for the removal of nutrients and hydration, there has been 100 applications to the court of protection.

Now while most of those have gone through, some of them have been rejected by the court of protection because the medical assessment may not have been adequate or there may be disagreement between some of the members of the family which wasn't portrayed in the original application. I think we have to be very, very careful in removing safeguards which are there to prevent lives being taken.

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Sputnik: Has there been any response from the relatives of patients?

Alistair Thompson: Well the relatives who have gone through the court of protection system generally find it quite a difficult situation; they want to get on with the action of removing nutrients and hydration, but have to go through a very expensive and sometimes complex process. We believe it can be made easier and more effective and less adversarial without removing it altogether. But the Supreme Court has decided that they should remove this layer of protection, this important safeguard from very vulnerable people completely.

Sputnik: Wouldn't withdrawing food and liquids to allow such patients to die make them suffer from hunger and dehydration for days before they die?

Alistair Thompson: Yes, it will, it can take up to two weeks before someone succumbs to, mainly, dehydration, which leads to organ failure and death. It's not a nice way to go. Conversely, we shouldn't allow this to be used as an argument for removing other safeguards that prevent assisted suicide and euthanasia in the UK.

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Sputnik: What would be your message to those who speak out for euthanasia?

Alistair Thompson: I think this case is very different. I think this case has raised some serious ethical questions; but the MPs have looked at assisted suicide and euthanasia repeatedly — 10 times in the last 12 years or so — and they've always rejected changing the law, whether they're in Scotland, London or indeed in Guernsey, like earlier this summer. We shouldn't conflate those things.

What we need to have in the UK is a debate on how we care for an aging population; how we can ensure that the NHS is properly funded. Because at the moment, we're in a crisis in the NHS and if we don't get that right, then the pressure will come, potentially, to end patients' lives because the caring for people at the end of life is very, very expensive.

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