Case 1 - end of life

Question 1

what are the different types of non-natural deaths

Answer 1

murder
Manslaughter (+/- gross negligence)
Mercy killing
Euthanasia: active v passive and voluntary vs non voluntary
Suicide
Physician assisted suicide
Accidental death
Combat self defence

Question 2

what is manslaughter gross negligence

Answer 2

a failure to meet the appropriate standard of care, resulting in death, through action or omission sufficiently negligent to amount to a crime

prison time is 10-14 years

Question 3

what is the Suicide Act 1961

Answer 3

Decriminalised suicide
created an offence of intentionally encouraging or assisting the suicide or attempted suicide of another person…whether or not a suicide or an attempt at suicide, occurs.’

Question 4

what is active voluntary euthanasia

Answer 4

includes ‘assisted suicide’
Requested by the patient
Administer by another e.g dignities
Illegal but may not always be prosecuted if occurs abroad

Question 5

what is passive voluntary euthanasia

Answer 5

elective cessation of treatment - patient’s consent or request
Legal, non-contentious
E.g ADRT
Harry Blackwell

Question 6

what is active non-voluntary euthanasia

Answer 6

murder
Manslaughter
Illegal but v occasionally prosecution may not meet ‘public interests’ test

Question 7

what is passive non-voluntary euthanasia

Answer 7

if treatment of no clinical benefit then may be permissible
Vulnerable to allegation of negligence/manslaughter

Question 8

what are the ‘for’ arguments in euthanasia

Answer 8

Autonomy
Right to die
Compassion / cruelty
Dignity
Equality (as suicide isn’t illegal)

Question 9

what are the against arguments in euthanasia

Answer 9

sanctity of life
Protection of vulnerable
Slippery slope
Palliation
Doctor patient relationship

Question 10

what are the potential fatal side effects of opiate analgesics

Answer 10

respiratory depression

Question 11

what is the doctrine of double effect

Answer 11

it is morally indefensible to intend to harm an innocent person, but it is morally defensible to perform actions with good intended consequences, where harm is a foreseen but unintended consequence

difficult to define what constitutes ‘intended’ - especially if the harm is highly likely to happen - where is the probability threshold

often critisised

Question 12

what type of euthanasia is uncontentious and legal in the UK

Answer 12

voluntary passive euthanasia

Question 13

what type of euthanasia is illegal

Answer 13

active euthanasia

Question 14

what does the doctrine of double effect allow doctors do

Answer 14

administer medication which may be lethal, as long as the primary purpose is therapeutic

Question 15

when would prosecution be less likely to prosecute

Answer 15

the victim had reached a voluntary. Clear, settled and informed decision to commit suicide
The suspect was wholly motivated by compassion;
The actions of the suspect, although sufficient to come within the definition of the offence, were of only minor encouragement or assistance
The suspect had sought to dissuade the victim from taking the course of action which resulting in his or her suicide
The actions of the suspect may be characterised as reluctant encouragement or assistance in the fact of a determined wish on the part of the victim to commit suicide
The suspect reported the victims suicide to the police and of the suicide or attempt and his or her part in providing encouragement or assistance

Question 16

which people have the right or duty to dispose of a dead body through burial, cremation or export etc

Answer 16

person’s beneficiaries, the coroner, local authorities

Question 17

what has to happen before any of these disposals can take place

Answer 17

a medical certificate of cause of death MCCD must be issued - usually by a doctor, occasionally a coroner, and taken to the local register office to register death, usually within 5 days if possible

Question 18

when must you speak to the coroner

Answer 18

you (the doctor) have not seen the patient within the previous 14 days
The cause of death is not known
Death occurred within 24 hours of admission to the hospital
Death related to surgery or anaesthetic
Sudden, unexpected, violent, suspicious or unnatural deaths
Death due to trauma or poisoning including acute alcohol or drug intoxication
Death from an industrial disease
Neglect plated a role in the death
Deaths in prison or police custody.

Question 19

who is the coroner?

Answer 19

an independent judicial officer - a freestanding office, unrelated to police, crown or civil court systems
Around 100 jurisdictions - approximate to local authority boundaries
Legal ( or bioscience) qualification and experience
Procurator fiscal in scotland.

What Is their role?
establish who has died and how they died
Inquests - and can issue a death certificate if you can’t
NOT deciding who has committed a crime - although coroner’s verdict may influence police, CPS or civil courts