Thursday 4 February 2010

Daily Telegraph gives good news on PVS patients a sinister twist

The headline of the top story on the front-page of today's Telegraph reads: "Patients in 'vegetative' state can think and communicate".  It's exciting stuff and well worth reading.

Readers of the Telegraph who remember the 1992 House of Lords judgment in the case of Tony Bland (pictured right with his mother) could be forgiven for thinking that the story would suggest that, perhaps, the judges got it wrong in the Bland judgement. No such luck I'm afraid. Indeed, in my view, the Telegraph gives this thoroughly "good news" story a sinister twist.

(For those who don't know about Tony Bland, he was seriously injured in the Hillsborough Stadium tragedy of 1989, leaving him in a persistent non-responsive state – often called a “persistent vegetative state” [PVS]. He could breathe by himself and assimilate foods and fluids administered by tube, yet following a High Court application by the Airedale Hospital trust, a decision was made to remove his feeding tube. That decision was upheld on appeal and by the House of Lords. Tony died nine days after the tube was removed. You can read more about him in a post of mine last September.)

Alison Davis of No Less Human has given me the following thoughts on today's story:
"It seems that the main preoccupation of the authors of this story on direct communication with supposed 'Persistent Vegetative State' (PVS) patients is that they may 'choose to die'.

"When one thinks about the many thoughts and ideas that people may want to express who have been silenced by their physical condition for five years or more, one would guess that the so-called 'right to die' would be low on their list of priorities. Nevertheless, Jacob Appel, an American 'medical ethics expert' appears to assume not only that they will have these thoughts, but that if they do, doctors will have an 'ethical obligation' to kill them.

"However, the greatest arrogance and presumption is reserved for the final sentence of the article, where it is claimed that it is 'doubtful' that the 'mercy killing' of Tony Bland in 1993 would be affected by the new technique since 'he was thought to be in an extreme form of PVS.'

"This assumes that the state of medical knowledge 17 years ago is unchanged today. It also makes the reader wonder whether the writers of this sentence had actually read their own story. The people with whom doctors communicated successfully using the new technique were equally sure that their patients were in 'PVS' - until they communicated with them. Who is to say that Tony Bland could not have had the same ability?

"However, that is not the most important point. Whether or not a person said to be in 'PVS' is rightly or wrongly diagnosed makes not a jot of difference to their right to life, however restricted, attended by the best care and technology available, until they die naturally."
Alison Davis, in a recently published paper, shows how euthanasia has spread, starting with the 1992 Bland judgment, and has expanded as a result of the 2005 Mental Capacity Act and is now implemented through the Liverpool Care Pathway.

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