Today, 24[1]<\/a>000 The issue of euthanasia has become increasingly Thus, a Europeanisation of legislation on the end of As for the European Court of Human Rights, it has The United Kingdom has some legislation on end-of-life More recently, in An Before studying the law and the judgments in more In the most concrete cases, we note that passive However, it is impossible for the patient to kill This essay is based on the statement of Dr. Peters Before The In this case, Unfortunately, In this case, Consequently, in the event of suicide, only failure to Thus, complicity in suicide is legal in the United Kingdom. Politicians With the First, with Trust v. In Bland[8]<\/strong><\/a><\/em>, On this It is retained In 1957, in With regard to In Airedale NHS Trust v. Bland<\/em>, Lord Mustill The doctor In Airedale NHS Trust v. Bland<\/em>, Lord Keith of Kinkel When the In the present This court The Thus, the This article 2 In particular, The Court The second The article 14 The article Thus, in order Dr. Peters In addition, With regard to However, the It is also It is only in To Cases<\/strong><\/p>\n Statutes and statutory instruments<\/strong><\/p>\n EU legislation and cases<\/strong><\/p>\n European Court of Human Rights<\/strong><\/p>\n Books<\/strong><\/p>\n Journal articles<\/strong><\/p>\n Websites and blogs<\/strong><\/p>\n [1]<\/a> [2]<\/a> [3]<\/a> Airedale N.H.S. Trust v Bland [1993] A.C. 789<\/p>\n [4]<\/a> An NHS Trust and others (Respondents) v Y (by his [5]<\/a> [6]<\/a> [7]<\/a> Article 4 of the Homicide Act 1957<\/p>\n [8]<\/a> Trust v. In Bland 1993 (A. C. 789)<\/p>\n
\npeople are reported to be in a vegetative or minimal conscious state in the
\nUnited Kingdom. Medical advances have increased life expectancy and also made
\nit possible to artificially maintain the lives of patients in comas that are
\nconsidered irreversible. By these means, in developed countries and since the
\n2000s, there has been an increasing number of people who want the choice to
\ndecide for themselves when they will die.<\/p>\n
\nimportant since the end and beginning of the 21st century. Some countries have
\ndecriminalized active euthanasia, such as Belgium or the Netherlands, or even
\nallowed assisted suicide, such as Switzerland.<\/p>\n
\nlife seems more than hypothetical. The issue of euthanasia has not been studied
\nby the European Parliament.<\/p>\n
\nruled several times, notably on 29 April 2002 in the case of Pretty C. United Kingdom[2]<\/strong><\/a><\/em>.
\nIn that judgment, Articles 2, 3, 8, 8, 9 and 14 were raised by the applicant.
\nThe Pretty v. United Kingdom<\/em> case
\nprovides a better definition of the contours of these articles.<\/p>\n
\ncare. There are two criminal laws: the Homicide Act of 1957 and the Suicide Act
\nof 1961 and several judgments concerning the interruption of artificial feeding
\nand hydration of a patient who was in a vegetative state (Airedale NHS Trust V.
\nBland[3]<\/a>).<\/p>\n
\nNHS Trust and others v Y and another[4]<\/strong><\/a><\/em>,
\nthe judges specified under certain conditions that recourse to a court to stop
\nthe care of a patient in a vegetative state was not mandatory.<\/p>\n
\ndetail, it is important to define the terms of the subject. There are several
\nways to end the life.<\/p>\n\n
\nwhich decriminalizes suicide and its attempt.<\/li>\n
\nis implied in the Homicide Act<\/em>[6]<\/a>.
\nIn 1957, both types of euthanasia were considered to be murder with a softer
\npenalty, when one person kills another in accordance with a suicide pact
\nconcluded between them[7]<\/a>.<\/p>\n\n
\nof a third party who administers a lethal substance to a patient in order to
\ncause immediate death.<\/li>\n<\/ul>\n\n
\nrenunciation of drug treatments, the interruption of food or artificial
\nhydration or the administration of opiates or high-dose sedatives, which can
\nput the patient in a coma and cause death after a few days.<\/li>\n<\/ul>\n<\/li>\n
\nprovides the patient with a deadly substance that the patient administers for
\nhimself. This is the path Switzerland has chosen.<\/li>\n
\ncharacterized by the absence of any behaviour indicating conscious activity:
\nlanguage, significant behavioural response, clearly voluntary behaviour.<\/li>\n<\/ul>\n
\neuthanasia is carried out in the case of seriously ill patients. These patients
\nhave a persistent vegetative state. In this case, patients are locked in their
\nbodies, they can only control a tiny part of it, breaking most communications
\nwith other people. It is therefore quite conceivable that this state is
\ndesperate. Therefore, the problem related to the patient’s end-of-life is of a great
\nimportance.<\/p>\n
\nhimself by his own means. If that were the case, we would call it a suicide and
\nthe problem would be solved. In fact, for this type of patient, a person must
\nbe able to help him kill himself. Consequently, certain conditions must be met
\nin relation to the medical profession.<\/p>\n
\nSaunders, who had expressed some hesitations about the solution provided by the
\njudges. In An NHS Trust and others v Y
\nand another<\/em>, Mr Y suffered a cardiac arrest in June 2017, this man was in a
\nvegetative state and required nutritional and moisturizing care to be kept
\nalive. According to the medical staff, his chances of regaining consciousness
\nwere minimal and, if so, the risks of severe disability were very high. His
\nfamily and doctors then chose to remove his nutrient tube and let him die. The
\nNHS Trust went to court to declare that it was not mandatory to obtain a
\njudicial declaration to stop care if the medical profession and family agreed.
\nThe court answered in the affirmative way.<\/p>\n
\nunderstanding the motivations and contribution of this statement (II), it is
\nimportant to understand the notion of end of life in the light of national and
\nEuropean texts and decisions (I).<\/p>\nThe legal framework of the end-of-life concept<\/h3>\n
\ndifficulty of this subject lies in the definition of acts to kill oneself.
\nIndeed, according to each act, it is possible to predict whether or not it is
\nillegal or not, but also whether it is contrary to international principles.<\/p>\n\n
\nact may emanate from the person himself:<\/li>\n<\/ul>\n
\nthe United Kingdom legislation is followed with the Suicide Act of 1961. This
\nlaw allowed the decriminalization of suicide and its attempt.<\/p>\n
\nthere are cases where the person cannot kill himself or herself on his or her
\nown. This is the case for patients in a persistent vegetative state. <\/p>\n\n
\nthe help of a third party is required:<\/li>\n<\/ul>\n
\nthere are two main sections, euthanasia and assisted suicide.<\/p>\n\n
\nunder certain circumstances. Indeed, the Supreme Court considers suicides to be
\naccidents within the meaning of article 323c of the Criminal Code, which
\ncondemns failure to assist a person in danger in the event of an accident,
\ngeneral danger or necessity. <\/li>\n<\/ul>\n
\nassist a person in danger is liable to be punished (fine or prison sentence of
\nup to one year). <\/p>\n
\nIn other words, case law quite widely tolerates assisted suicide when the
\npatient is physically able to perform the decisive action. On the other hand,
\nit is very demanding in determining whether suicide has occurred in the case of
\npeople with severe disabilities.<\/p>\n\n
\nmeans, we will speak about euthanasia. In the United Kingdom, euthanasia is not
\na particular offence. She is prosecuted on the grounds of murder, willful
\nmurder or assault.<\/li>\n<\/ul>\n
\nprohibited all forms of euthanasia with the Homicide
\nAct<\/em> in 1957. It is true that at that time, cases of patients suffering from
\nan incurable disease and remaining alive were rare due to the medical resources
\nat this time.<\/p>\n
\nevolution of medicine and the impetus of the judgments of the European Court of
\nHuman Rights, judges have relaxed this rule of law. <\/p>\n
\nthe House of Lords ruled on the interruption of artificial feeding and
\nhydration of a patient who had been in a persistent vegetative state since
\n1989, following an accident in a football stadium.<\/p>\n
\noccasion, the court recalled the main principles that apply to all those who
\nare confronted with the problem of euthanasia:<\/p>\n\n
\nthat active euthanasia is strictly prohibited but passive euthanasia is
\nallowed. Before studying passive euthanasia, it is important to highlight a
\nthird form of euthanasia: indirect euthanasia. Jurisprudence has long allowed doctors
\nto administer analgesic drugs, even though this has the predictable but
\nunintended side effect (or double effect) of giving death.<\/p>\n
\nthe case of Dr. John Bodkin Adams[9]<\/a>,
\none of the first cases to be heard by the courts, the judge stated that \u201c[a doctor] is entitled to do all that is
\nproper and necessary to relieve pain even if the measures he takes may
\nincidentally shorten life\u201d.<\/em><\/p>\n
\nactive euthanasia, the problem lies in the patient’s consent. Indeed, patients
\nsuffering from a persistent vegetative state cannot always express their
\nconsent due to the seriousness of the disease.<\/p>\n\n
\nrecalled that \u201cparamountcy of the
\npatient’s choice. If the patient is capable of making a decision on whether to
\npermit treatment and decides not to permit it his choice must be obeyed, even
\nif on any objective view it is contrary to his best interests. A doctor has no
\nright to proceed in the face of objection, even if it is plain to all, including
\nthe patient, that adverse consequences and even death will or may ensue<\/em>\u201d<\/p>\n
\ncannot be prosecuted, both in civil and criminal proceedings, if he has clearly
\ninformed the patient about the entire treatment, including its side effects,
\nhas faithfully answered all his questions and has ascertained the reality of
\nhis intention to die<\/p>\n\n
\nhave drawn up a living will<\/li>\n<\/ul>\n
\ndescribes the right of a person to refuse treatment, even if his refusal causes
\nhis death, and adds \u201cthis extends to the
\nsituation where the person, in anticipation of his, through one cause or
\nanother, entering into a condition such as P.V.S., gives clear instructions
\nthat in such event he is not to be given medical care, including artificial
\nfeeding, designed to keep him alive<\/em>\u201d.<\/p>\n\n
\nhave not drawn up a living will<\/li>\n<\/ul>\n
\npatient is in a persistent vegetative state, it is legal to stop taking drugs,
\nespecially antibiotics. In Airedale NHS
\nTrust v. In Bland<\/em>‘s view, the judges considered that it would have been
\nappropriate, both ethically and practically, to discontinue antibiotic treatment
\nas soon as there was an agreement to that effect between the medical team and
\nthe family.<\/p>\n
\ncase, the Court also authorised the cessation of artificial feeding and
\nhydration. However, the legality of stopping artificial feeding and hydration
\nis not clearly established and the British Medical Association advises doctors
\nto obtain a court decision beforehand.<\/p>\n
\ndecision is therefore no longer mandatory following the judgment of An NHS Trust and others v Y and another<\/em>.<\/p>\n
\nnotion of end-of-life is not only based on methods but also on principle. In
\nother words, the question is whether we have the choice to decide our death.<\/p>\n
\nright to life is a fundamental right enshrined in various international texts. The
\narticle 2 of the European Convention for the Protection of Human Rights
\nprovides that \u201ceveryone’s right to life
\nshall be protected by law<\/em>“. This general rule implies that each State
\nmust include in its legal arsenal laws aimed at protecting human life. In
\naddition, the article provides a framework for the means by which the right to
\nlife may exceptionally be violated.<\/p>\n
\nis the first source of controversy on euthanasia. Euthanasia does not appear
\ndirectly in the text. As a result, the court was repeatedly asked for this
\nquestion. As the judgments progressed, it refined the principle of the right to
\nlife.<\/p>\n
\nin Pretty v. the United Kingdom[10]<\/strong><\/a><\/em>.
\nThis judgement raised several articles of the convention. One of the important
\nquestions was whether the right to life in article 2 is a corollary principle
\nto the right to death. The applicant, who was suffering from a serious
\nincurable disease, requested that her husband help her die. However, at that
\ntime in the United Kingdom, helping a person to die was considered assisted
\nsuicide and therefore illegal. The husband could therefore be prosecuted. The
\nEuropean Court of Human Rights held that Article 2 could not be interpreted as
\na right authorising death. <\/p>\n
\nrefused the applicant’s argument but did not condemn euthanasia. It considers
\nthat these are matters for the free appreciation of States but that there is no
\nright to die.<\/p>\n
\nsource of controversy is Article 3 of the European Convention on Human Rights.
\nIt provides that \u201cno one shall be
\nsubjected to torture or to inhuman or degrading treatment or punishment<\/em>“.
\nThis article was raised in Pretty v. the
\nUnited Kingdom<\/em>. Indeed, patients at the end of their lives suffer
\nenormously and it is the responsibility of each State to take positive measures
\nto prevent this suffering.<\/p>\n
\nof the Convention was also raised in Pretty
\nV. United Kingdom case<\/em>. This is interesting because Article 14 lays down
\nthe principle of the prohibition of discrimination. Indeed, the applicant had
\nargued that suicide was legal in the United Kingdom and that the State refused
\nto allow her to commit suicide. The court held that suicide was legal when it
\nwas done by the person himself and not by a third party even in the case of a
\nmajor disability.<\/p>\n
\nII-2 of the Charter of Fundamental Rights of the European Union that \u201ceveryone has the right to life<\/em>“.
\nThis sentence is as general as Article 2 of the European Convention for the
\nProtection of Human Rights. However, the Court of the European Union (28
\ncountries), ensures compliance with the Treaties and European law, and can
\nsanction all violations of them, whether they come from the European
\ninstitutions, governments, companies or individuals person. It has a monopoly
\non the interpretation of European law throughout the Union. The decisions are
\nbinding. National judges must make it decide any doubt as to the meaning of a
\nprovision of European law.<\/p>\n
\nto bring an action before the Court of the European Union, it is necessary to
\nraise an illegality or inconsistency in the European Union treaties. As a
\nresult, its effectiveness is less than that of the European Court of Human
\nRights.<\/p>\nAn unpragmatic statement<\/h3>\n
\nSanders pointed out that patients will suffer when care is stopped. It is
\nunderstandable that discontinuation of care can be considered as degrading
\npunishment or treatment. However, the time lapse between the cessation of care
\nand the patient’s death is minimal compared to the months, years of suffering
\nthat the patient may experience.<\/p>\n
\nhe adds that a court decision provides an additional level of protection. It is
\ntrue that a court decision makes it possible to better reflect on the relevance
\nof stopping care. But first, as we have seen in the above judgments, the court
\ndecision was advised and not binding. In addition, it may take months to get an
\nanswer. This has the effect of causing potential suffering, thus the cost of
\njudicial request is not very cheap.<\/p>\n
\nthe last point, on the fact that decisions may be taken for the wrong reasons.
\nThe answer here is more nuanced. Indeed, whether in the public or private
\ndomain, the misfortune of one is the happiness of the other. In other words, a
\ndeceased patient is a vacant bed for the hospital but also a legacy for the
\nbereaved family.<\/p>\n
\nfinal decision must be made between the doctor, the patient and the patient’s family.
\nAs we have seen, it is possible that the patient had made his wishes known
\nthrough his will, cancelling the margin of responsibility for the other two
\nparties. <\/p>\n
\npossible that out of the 24,000 patients in vegetative states can communicate,
\nthus reducing the margin of responsibility for the doctor and family. <\/p>\n
\nthe case where the patient has not expressed his wishes that Dr. Peters
\nSanders’ sentence makes sense. Fortunately, however, the doctor is subject to
\nethical and deontological rules. In France as in the United Kingdom, students
\nmust say the Hippocratic Oath. In France, this oath has legal force. Indeed,
\ndoctors are obliged to help people in difficulty, whatever the situation. This
\noath, inspired by the famous Dr. Hippocrates, imposes a duty of care on all
\ndoctors, thus preventing them from committing acts with regard to another
\naspect such as the financial aspect. Finally, the court decision is binding in
\nall other cases. In other words, as soon as there is any doubt about the choice
\nof the patient’s end-of-life, referral to the courts is mandatory.<\/p>\nConclusion:<\/h3>\n
\nconclude, the theme of the end of life is important and topical. The fact that
\nthere is no specific and common regime for these issues leads to judicial
\ninstability. There are many texts guaranteeing the right to life, such as
\nArticle II-2 of the Charter of Fundamental Rights of the European Union or
\nArticle 2 of the European Convention for the Protection of Human Rights.
\nHowever, their common point is that they have been written in such a way that
\nthere are several interpretations, so that the texts can exist over time. It is
\ntherefore the responsibility of the European Court of Human Rights to refine
\nthe articles of the Convention on a case-by-case basis. In addition, the
\narticles of the Convention are of a supranational nature and are directly
\napplicable in the courts. It is therefore the duty of each State to comply with
\nthe solutions of the Court.<\/p>\nBibliography<\/h3>\n
Primary sources:<\/h4>\n
\n
\n
\n
\n
Secondary sources<\/h4>\n
\n
\n
\n
\n
\nhttp:\/\/www.rfi.fr\/europe\/20180731-royaume-uni-une-nouvelle-loi-fin-vie-euthanasie<\/p>\n
\nPretty v. United Kingdom \u2013 2002 (2346\/02)<\/p>\n
\nlitigation friend, the Official Solicitor) and another (Appellant)[2018] UKSC
\n46<\/p>\n
\nSuicide Act 1961<\/p>\n
\nHomicide Act 1957<\/p>\n