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Cases in history

Profiles: Bland / Cox / Rodriguez / Re C / Quinlan / Sanpedro / Cruzan / Malette / Conroy / Johnstone


In March 1993 Anthony Bland had lain in persistent vegetative state for three years before a Court Order allowed his degradation and indignity to come to a merciful close. The judges said that if he had made a living will expressing his future wishes he could have been allowed to die in peace earlier. Exit is at the forefront of living will research in the UK. Your subscription will help to make a peaceful death through a living will a reality for anyone who desires it.

In 1992 Dr Cox openly defied the law and assented to 70 year old Mrs Boyes' persistent request for voluntary active euthanasia. Mrs Boyes' was so ill that she "screamed like a dog" if anyone touched her. Conventional medicine did not relieve her agony. In her last days, when she repeatedly requested to die, Dr Cox finally gave her an injection of potassium chloride, bestowing on her the boon of a peaceful death so many of us feel we are entitled to. Dr Cox, although given a suspended sentence, was hauled through the courts like a common criminal. We believe good doctors acting in all conscience like Dr Cox, should be lauded, not vilified, and should have the benefit of legally approved codes of conduct that embody consistent safeguards against abuse. Together we should ensure that medicine and the law serve the patient and the citizen once more. Together, we can stand and be counted. And, from pooled resources, each small contribution will contribute to the powerful tidal wave that Exit can use to bring this about.

Sue Rodriguez, a mother in her early thirties, died slowly of Lou Gehrig's disease. She lived for several years with the knowledge that her muscles would, one by one, waste away until the day came when, fully conscious, she would choke to death. She begged the Courts to reassure her that a doctor would be allowed to assist her in choosing the moment of death. They refused. She lived on in terror, helped eventually by a doctor who, in February 1994, covertly broke the law to help her die in peace. A law on assisted suicide with rigorous safeguards could have saved her the nightmare during those months before her death, given her the confidence to carry on - with the reassurance that when it got too bad she could rely on a compassionate doctor to follow her wishes at the end. Exit is pledged to support research for drafting the most thorough, yet feasible, assisted suicide Bill yet presented to Parliament. Your support will make it happen.

"Mr C", a 68 year old prisoner of Jamaican origin had been diagnosed as suffering from chronic paranoid schizophrenia and was treated with drugs and electro-convulsive therapy. In September 1993 the prison doctors found he had gangrene in his right leg. They felt his chance of survival with conventional treatment was no better than 15%, and so recommended that his leg be amputated below the knee. The prisoner refused amputation and received conventional treatment only. There was a likelihood, however, that gangrene would recur. The prisoner stated he would rather die on two legs than live on one, and his solicitor asked the hospital to promise not to amputate in any circumstances without the prisoner's consent. They refused, and he sought a court injunction to uphold his wishes. The court considered expert testimony in the case (known as Re C) and found that, although the prisoner was suffering from schizophrenia, there was nothing to suggest that he did not understand the nature, purpose and effects of treatment; he had understood, and, with a full knowledge that death might result from refusing amputation, had clearly made his choice. The court upheld the prisoner's right to make an advance refusal of treatment and granted an injunction. The case paved the way for acceptance of advance refusals of medical treatments and so for living wills. Completion of an Exit living will document could save distressing and drawn-out court proceedings if ever you were incapacitated.

Karen Ann Quinlan collapsed on April 15th, 1975. She was twenty-one years old. Within hours, she entered a coma from which she could never recover. Her parents, staunch Roman Catholics, knew their daughter would not want to be kept alive by extraordinary means. A year later, as Karen lay in a "persistent vegetative state," the courts finally allowed her treatment to be stopped; but artificial feeding was continued and she was maintained as a living corpse until June 1985, when she eventually died of pneumonia. Her case spurred thousands of letters of sympathy and fuelled the "right to die" movement. How many people need to die degrading deaths before society learns a little humanity? Exit is committed to research and teaching in these difficult areas. Help us to help you, and all those who would seek die with dignity and give you their heartfelt thanks.

Ramon Sanpedro sought, through the courts, the assistance of a doctor to help him die with dignity. He was paralysed in Spain as a result of a swimming accident during his youth. He described himself as "a head attached to a corpse." He wrote:
"Why die? Because every journey has its departure time and only the traveller has the privilege and the right to choose the last day to get out. Why to die? Because at times the journey of no return is the best path that reason can show us out of love and respect for life, so that life may have a dignified death."
Ramon Sanpedro made no suggestion as to what the wishes of others in a similar physical condition might be. In fact, some people who are so paralysed take enjoyment in life and want to go on living. Their choice should be respected and they should be given every support. But Ramon Sanpedro made his choice and choice should be respected. We should seek to ensure that the rights of the individual are always respected without allowing others to feel endangered or pressurised. Exit provides international technical and informational support. With your help, we can make the world a better place.

Nancy Cruzan lost control of her car one day in January 1983 in Missouri. When the paramedics arrived, they were able to restore her breathing and heartbeat and she was transported, unconscious, to hospital. She continued to be fed through a surgically- implanted gastrostomy tube. After several years, a court found that, although her respiration and circulation continued unaided, she was oblivious to her surroundings except for reflexive responses to sound and perhaps painful stimuli; her brain had degenerated, irreversibly; she was a spastic quadriplegic; she suffered contraction of her four extremities, with irreversible muscle and tendon damage; and had no cognitive or reflex ability to swallow food or water or to maintain her essential daily needs nor would she ever recover such an ability. She lay in persistent vegetative state even though she had told her housemate that, if sick or injured, she would not wish to continue her life unless she could live "at least halfway normal." This was the first time the U.S. Supreme Court had been faced with what we call the "right to die." They said that Missouri had "arrogated to itself" the power to define life, and Nancy Cruzan's life and liberty consequently put into disquieting conflict. She had not made a living will, and the court case paved the way for a uniform, national Patient Self- Determination Act that regulated living wills and made them more widely available. Exit is campaigning for uniform UK reform to make living wills more widely available. Your help can make it a reality.

57 year old Georgette Malette, in the early afternoon of June 30th, 1979, was rushed, unconscious, by ambulance, to hospital. The car in which she was a passenger, driven by her husband, had collided with a truck. Her husband had been killed; she had suffered serious injuries. She was a Jehovah's Witness and carried a card stating her firm conviction that no blood or blood products should be administered to her under any circumstances. The doctor treating her ignored the card and gave her a blood transfusion which he decided was medically indicated. In June 1980 Mrs Malette brought charges against Dr Shulman. The judge found that Mrs Malette had suffered emotionally and mentally and ordered substantial costs to be paid. It made no difference that the medical team didn't agree with her beliefs. Her advance refusal of treatment was unambiguous. Unfortunately, living wills tend to be far less clear cut, dealing with a wide range of circumstances in which interpretation is sometimes necessary. Exit is at the forefront of research into living wills and other ways of having your wishes respected at the end of life. Public support will help us to help make dying more dignified for all those who want to retain some control and self-respect in their dying phase.

When her case came to trial, Claire Conroy was unable to move from a semi-fetal position. She was severely demented, had heart disease, hypertension and diabetes and her left leg was gangrenous to the knee; she had sores, couldn't speak, had only a limited ability to swallow, and had eye problems; she had a urinary catheter in place and was unable to control her bowels. She was able to moan and scratch, and occasionally smile when someone combed her hair. Claire Conroy eventually died before the courts were able to decide what to do. She was not a candidate for voluntary euthanasia. She had not made a living will. But her case posed very worrying dilemmas about end of life decisions. Pushing difficult deaths to one side will not make them go away or make them any easier. Exit encourages open discussion of the problems increasingly facing us in society. We care, and we listen with an open mind. We ask you to work with us so that every person can die with dignity in the way that he or she would choose.

Copyright © 1996-2000 Chris Docker