Misunderstanding the Mental Health Act and Living Wills

Baroness Murphy

I was a going to blog about the Equality Bill this week, so much to say about it, both positive and negative but perhaps I’ll save that for when we return from Recess for the committee stages of the Bill. Instead I want to return to the right to die and the case of Kerrie Wooltorton, the young Norwich woman who died earlier this year as a result of her refusal to accept treatment to avert renal failure after she had deliberately consumed anti-freeze. She had called for an ambulance “so that she could end her life in a more comfortable manner in hospital than at home”. I want to explore this case again because of The Times headline this week that over half of MPs support the idea that a terminally ill patient should be able to request help to die at a time of their own choosing. I was much heartened by the survey results and am a strong supporter of Assisted Dying for the Terminally ill when the decision is made in the setting of full mental competence in someone free of any diagnosable mental disorder. I am also a strong advocate of living wills and advanced directives made when the person is competent to enable another person to make decisions reflecting an individual’s wishes when that person loses competence, now made legal under the Mental Capacity Act. But I was horrified by the decision not to treat Kerrie Wooltorton, angry at the lack of understanding of her long term mental disorder and even more shocked by the Coroner’s lack of understanding and the failure of training in the emergency services. It is possible that I don’t have the full facts but I have read everything I can find on this case. If I criticise unfairly then that will be because I don’t have all the facts.

Kerrie’s case is a good example of how a good law can be turned to evil in thoughtless ill-trained hands. Has no-one heard of the Mental Health Act? Kerrie had a difficult longstanding personality disorder, depression and inability to cope with her life situation. She had made many other attempts to kill herself in a similarly bizarre manner, testing the patience of her family and professional carers to the absolute limit. Patients like this are both difficult and unpopular. Does anyone really believe that drinking anti-freeze and the taking yourself off to an A&E room waving a so-called ‘living will’ is the act of a person who wants to die? Someone who wants to die makes sure no-one will find them before they are dead, they don’t ‘seek company while dying’ in that way. In a written statement made at the time, she had made clear that she would refuse any treatment and she did so, in full knowledge that she was most likely to die as a result. All the medical staff who attended her were unanimous in the view that she had capacity to refuse treatment at that point in time and that she did not have a mental disorder, so could not be sectioned under the Mental Health Act 1983. In my view they were profoundly wrong and don’t understand the Act. The coroner pointed out that her written statement was not considered an advance directive under the Mental Capacity Act but was just considered as “part of the overall evidence relating to her mental state at the time.”

There are two key points that I would like to make. The first is that it has been established (by the case of B v Croydon Health Authority) that treatment for mental disorder under the Mental Health Act can include treatment of the physical consequences of self-harm which results from that disorder. The Code of Practice for the Mental Health Act for England explains as follows: 23.3 The Act defines medical treatment for mental disorder as medical treatment which is for the purpose of alleviating or preventing a worsening of a mental disorder or one or more of its symptoms or manifestations. 23.4 This includes treatment of physical health problems only to the extent that such treatment is part of, or ancillary to, treatment for mental disorder (eg treating wounds self-inflicted as a result of mental disorder). Otherwise, the Act does not regulate medical treatment for physical health problems.” Accordingly, there are circumstances in which a person detained under the Act may properly be treated for the physical consequences of self harm without their consent.

The second point is that it is possible for someone to meet the criteria for detention under the Act even though they retain the mental capacity to take decisions about their treatment. So the need for detention under the Act is certainly one possibility to consider in the case of a patient who has seriously self-harmed as a result of mental disorder, even though they have the capacity to refuse treatment for their injuries (or have refused it by means of an advance decision). In that respect, they are no different from any other suicidal or self-harming patient. Kerrie Wooltorton had a long history of mental disorder which would almost certainly have improved with time and her depression was eminently treatable. I have no doubt whatever that she should have been sectioned under the Mental Health Act in order to facilitate her physical treatment. Her so called Living Will was invalid, a travesty, made in the setting of a long standing mental disorder.

No wonder her family are so distressed by the emergency services failure to intervene. No wonder too that those who oppose the right to make a personal decision about the time of death use this case to beat those of us who support assisted dying. We need far better professional training in clinical services and better understanding by lawyers of the natural history of mental disorders.

26 comments for “Misunderstanding the Mental Health Act and Living Wills

  1. nickleaton
    19/12/2009 at 12:32 pm

    Normally, I would say that the right to die is a personal choice issue. However, for a separate reason I’m against it.

    In my personal experience, I’ve seen too many errors in the health service. In 8 cases these have resulted in deaths. In one case in particular 5 doctors had made serious errors, and the surgeon in particular. The surgeon didn’t withdraw from the case and carried on treatment, in the end increasing the morphine dose to the level that the patient was killed off. Now that was a deliberate decision to aid the end of a life, and the cause was his errors. That’s so close to murder, that there is a reasonable chance of a prosecution. ie. Doctors who make mistakes should be taken out the decision on end of life care.

    That illustrates the issue. The current fudge is allowing doctors to get away with things.

    Secondly, there will be pressure from relatives and there will be doctors taking decisions without others being informed. There is also the case, as you point out of people with mental disorders.

    Now if this is one or two cases a year, its a separate matter. However, the NHS’s own research states that they contribute to 20,000 deaths a year. It’s not a small problem. I’ve personal knowledge of 8 deaths. The latest one has left 2 young children without a mother. With that level of error within the NHS, I’m against any right to die legistlation and I’m in favour for a change of new legistlation. The lasw need tightening up.

    The problem stems from the government being all three legs of the health system. Insurer, provider and regulator. They all need to be separated out.

    Lets take an example. The regulator (NHS) won’t get involved in regulation because to do so would mean that the NHS has to pay out large sums of compensation. [Current the concept is that the victim pays, because it might take money away from other patients] ie. If it can’t get the basics correct, it won’t get right to die correct.

    How does it compare to other countries? Well the only one that I’ve had direct experience of is Switzerland. When I first lived there, a surgeon had taken the wrong leg off. He was stopped from practicing and struck off. Period.

    http://www.dailymail.co.uk/news/article-408124/Compensation-payments-soar-patients-given-wrong-operation.html has examples. Any doctors been struck off? Nope.

    ie. With that level of care, what hope is there of right to life cases being dealt with properly?

    None

  2. Richard Lord
    19/12/2009 at 2:25 pm

    I take issue with two aspects of your post.

    1. Describing what happened to Kerry Wooltorton as “evil” is excessive and inflammatory. A mistake it may be, but it is not evil (or do you think someone involved deliberately acted against their better judgement to ensure that Kerry died?).

    2. You assume that someone who wants to die won’t want company while they die. Do you have facts to back up this opinion? A friend recently died of cancer. When his death was inevitable, he left hospital so that he could die at home with his family. He, like many others, wanted company when he died. How can you be so sure that Kerry didn’t also experience this same, simple human desire for company at the end and turn to those she felt confident would not try to prevent her death to provide that company.

    It seems inevitable, unfortunately, that there will be a clash between any act giving one the right to die and the mental health act. This is because the desire to die and the will to act on that desire will often be sufficient for one to be classified as mentally ill. In other words, exercising one’s right to die under the former act may cause one’s right to die to be withdrawn under the latter act.

    It is left to the medical profession to attempt the task of walking a careful and difficult line between two conflicting acts. That they will make mistakes is inevitable. That they will receive criticism from the press, the public, and politicians is even more inevitable. That they will always do their very best for each individual patient is the great comfort in all of this.

    • Nick
      19/12/2009 at 5:23 pm

      It is left to the medical profession to attempt the task of walking a careful and difficult line between two conflicting acts. That they will make mistakes is inevitable. That they will receive criticism from the press, the public, and politicians is even more inevitable. That they will always do their very best for each individual patient is the great comfort in all of this.

      The problem relates to the case I talked about. The surgeon had screwed by, by not doing the basics. The end result was that he had to eviserate the person. Remove almost all of contents of their lower abdomen. Can you live? A small chance. However his solution was to increase the morphine dose to a level that they died.

      Should the person who made the mistake be involved in that decision?

      Should the person who makes a basic error such as not taking a swap (operating 101) be allowed to treat any patient?

      If so, why should they be left to make any life or death decision as you suggest, in private and in secret as it is now?

      That’s wrong. For a start, it should take two doctors minimum, who aren’t involved in the case. It should require court approval.

      The problem is that the secrecy can, is and will be used for all sorts of other things with far greater harm.

      It needs to be stopped.

      It’s a failure of government to allow doctors to make life and death decisions in this way without the involvement of the courts.

      Nick

  3. Carl Holbrough
    19/12/2009 at 5:16 pm

    Not knowing the case and not being privvy to all that happened my view can only be generalised.

    I would certainly agree with Richard Lords point 1. However, noting how Baroness Murphy has appeared emotive in a couple of blogs her view is perhaps understandable. Having pigeon holed the noble Baroness snugly under “Mother”, which is not meant in anyway derogatory, it is easy to understand a maternal caring viewpoint.

    Even knowing the full facts, post events, may not be enough to state there was anything foul in the deeds. It is very much similar to the soldier at the checkpoint when a car rams through making an instant decision to fire or not. You have to be in the situation to decide ( thinking Corporal Lee Clegg jailed for murder 1993 ).

    The problem with mental illness is that there can be various view points that amount to a diagnosis but no actual physical test, in most cases. I`ve alway`s found the view that in a given situation someone who is guilty of the most horrendous murder pleads insane to be unjust. Since insanity is based on what is abnormal and generally most of us do not go around committing hideous murders, surely this MUST mean everyone who does is insane ? This is insanity in itself.

    One of course does not have any wish to die or commit suicide if life is great and all is rosy. Therefore it follows that most people who want to commit suicide are depressed. I`m sure if I was invalided in any great way it would depress me even to the extent of wanting to end my life but that in no way makes me insane or unable to make judgement.

    In Kerrie`s case, the fact she made so much noise about the whole thing, calling the emergency services and waving bits of paper may appear, post events, to be at least eccentric but I wasn`t there. I do not know the full facts, nor do I know how they presented at that time, nor am I qualified to give a professional opinion. A long standing personality disorder is not enough to state insanity, psychopathy is such and many in business and politics could be assessed as suffering it.

    The maternal viewpoint that there is always hope and life must be protected is a valid one. It must be fostered but not at expense of the personal freedom of someones wishes that they can no longer tolerate the pain they feel. Pain and suffering are personal issues, I do not know that your headaches are any worse than mine there is no scale or measurement. People commiting suicide alone is the norm because society frowns upon it, it may not be what people actually want and having read material about the clinics who assist suicide it definitely appears people would rather do it with others present. I`m sure that is what Guy Fawkes had in mind !

  4. baronesssmurphy
    20/12/2009 at 5:35 pm

    Richard Lord: I make no apology for being ’emotive’ nor using the word ‘evil’ about what happened to this woman. It is regrettably very common for clinical staff not to understand the law relating to people with mental health problems in a way that would be quite unacceptable if a person is suffering from a physical illness but is treated incorrectly with fatal results. The patient can sue for negligence, or their relatives can after an unnecessary death. It simply isn’t OK for doctors to say that as they made the decision in good faith it’s all fine.

    Your second point, that many people want company when they die is of course true, indeed most people want their loved ones about them. You must see this is a world away from the histrionic ingesting of antifreeze and going to an A&E department waving a hastily written ‘don’t save me’ note. The messages are complex, I accept but she was surely not seeking comapny!

    Your third point is mistaken. there is no conflict between the Mental Health Act and a suicidal act, the evidence for mental illness is NOT the act, but the history of a long standing or pre-existing condition. And Carl Holbrough it is not necessary in English Law to be ‘psychotic’ to fall under the protection of mental health legislation.

    Carl H, lovely as it is to be labelled as motherly you have me completely wrong. I want much greater autonomy for patients who are mentally competent to make their own decisions, not less; we have too much paternalism in medicine.

    • Carl Holbrough
      21/12/2009 at 12:14 pm

      I apologise, my Lady, if I have you all wrong it was not meant offensively.

      Regards being psychotic I was merely trying to get across the fact that many people have personality disorders, mentioned in your initial blog, which seemed to indicate this and depression were enough for her to be sectioned.

      As I stated I do not know the full facts, nor am I professionally competent to be able to give opinion that matters. I do however have questions.

      What is the difference between physical pain and suffering and mental in this situation ? The loss and emotion are for the people left alive in most cases but what about in cases of dementia and the like ?

      With lives becoming increasing longer and cases of dementia like diseases on the increase, the burden on the budget etc., what are my Lady`s feeling on this ?

      Does my Lady feel that Doctors are correct in not treating smokers because of their addiction ? After all is this not some type of self harm ?

      Psychiatry is not something that deals with absolute known quantities and there are many theories without full understanding. There are even some branches which suggest “Love” is a psychiatric disorder, certainly there are a lot of acts carried out in love`s name which are illogical and criminal. This means we have to rely on the professional who is there at the time to make the call. Mistakes will be made as they are in any branch of medicine, and much else. Sadly at times this may result in loss of life, medicine is not perfect neither is politics.

      We cannot bring Kerrie back and try again, sadly, all we can do is learn a lesson. Surely the emphasis of any autopsy is to see where it went wrong and make sure it isn`t repeated not to label people as “evil” when in all honesty it may have been a bad judgement call. We all get it wrong at times, I do.

    • Croft
      21/12/2009 at 1:38 pm

      I don’t know the specific case so it’s hard to comment except in general terms. The system seems to do shades of grey badly. Having in the past sometimes ignored the proper wishes of patients (on the doctor knows best principle) it seems to have gone to the other extreme and now they appear reluctant/nervous about stepping in.

      More clarity in the law would I think help everyone.

  5. Gareth Howell
    20/12/2009 at 5:54 pm

    nickel eaton makes some very wise remarks in his reply to the Noble Lady, which express the gist of my own opinions on the matter.

    “am a strong supporter of Assisted Dying for the Terminally ill”

    I am not. Such things must be non-lawful to be effective.

    • Gareth Howell
      20/12/2009 at 6:16 pm

      I wonder how the emergency services would have responded if a similar case occured in which the A+E arrival had been an organ donor on wheels?

      Yes indeed; what happened to the rest of Ms Wooltorton’s organs, or is that a ‘private matter’?

      Were they harvested in the usual way?

      I say again, and this MAY be the cause of the Baroness’ indignation, that we live thanx to the NHS in a Latter day cannibalist society, which was highlighted in another Bill in the lords last fortnight on Haemophilia, the blood being an organ of the human body.

      “the taking yourself off to an A&E room waving a so-called ‘living will’ is the act of a person who wants to die? Someone who wants to die makes sure no-one will find them before they are dead, they don’t ‘seek company while dying’ in that way”

      It may well be, and they may well do; it would be a pity to waste those organs wouldn’t it, and how generous was Ms Woolnorton to donate her organs to somebody entirely unknown to her!

      As many organ donors comment:

      ” I can not thank the donor enough”

      Well; Well; Well……… NO.

      I did follow the discussion and felt that Ms Woolnorton had done too (surprising as it seemed)and was very misguided in thinking that the Medical profession within the NHS has any idea of morals and ethics whatsoever; that it is utterly unruled and unprincipled; that she had not followed the thought thru and had not realised that we live in a cannibalist society.

      If you want a spare part to a Car, you cannibalize it with another.

      I may say also Baroness that I have had a number of similar such posts deleted by the BBC in the past, since the BBC is the main Consumerist Sales agitatator for such activities to occur at all, and can not cope with the idea that there are hordes of cannibals roaming the UK town and country enjoying other people’s organs.

      Unpaid, free, for nothing, gratis.

  6. Gareth Howell
    20/12/2009 at 6:22 pm

    My above contention in the Haemophilia debate was strongly represented by one of the Lord Bishops in his cloth, so I am not the only person to understand the medical profession in such a way, or the bills and acts relating to it.

    Ms Woolnorton had the capacity and used it.

    If you have ever been accosted by a Kidney dialysis patient asking for your kidneys you would think again, about the NHS.

  7. Gareth Howell
    20/12/2009 at 6:31 pm

    The main protagonist to the Haemophilia bill, which may have been talked out due to being non-quorate(!)the Lord Bill morris, claimed that he was haemophiliac because he BLED FROM THE RECTUM…. and that consequently he represented Haemophiliacs.

    The Lord Bishop did point out that bleeding from the rectum was a matter of the use of the rectum, and sweet Fanny Adams to do with
    an inability to heal wounds naturally, and that the blood which is apparently INGESTED
    ORALLY by some haemophiliacs, by the admission of the promoter of the bill, is an organ of the human body.

    The peer presenting the bill was unaware of this; the bill may have been withdrawn.

    What in heaven’s name should people like Ms Woolnorton think, when there are fools going about with ideas like that in their minds?

    OF SOUND MIND Ms Woolnorton, whilst all the world of the NHS is losing theirs!!!!!!!!!!!

    I am sorry she cut short her life in such a way. May her soul Rest in peace.

  8. Gareth Howell
    20/12/2009 at 7:30 pm

    Sad, Baroness, Sad.

  9. Gareth Howell
    20/12/2009 at 8:49 pm

    Furthermore I follow up the logic of the Lord Bishop’s remarks by saying that there is absolutely no evidence whatsoever that the purpose of the Christian sacrament of the body and blood of christ, had anything to do with real cannibalism in the world outside the Roman empire at that time. It was merely a considerable threat to those who did not want to acknowledge their subservience to Rome!

    The evidence of cannibalism has certainly been available in certain parts of the world in recent years, in Africa, South America and
    South sea Islands, but to suppose there were EVER cannibalist tribes just outside the Roman world at the time of Christ,is almost certainly a mistake.

    It is therefore almost certainly also a mistake to suppose that is in the least bit generous in any Christian sense, to “donate” organs to others in either a voluntary or deliberate act of self sacrifice.

    It is not; it is sacrilegious, and the State should invest far,far more in NOT being involved with such precise, and yet such barbaric and primitive, clinical surgery.

    The state and health are far from being synonymous,(why should they be?) but because the monopoly of the NHS is backed up so vigorously and forcefully, by for example, the Sections of the Mental Health Act, it becomes quite clear to innocents such as Ms Woolnorton, that they are.

  10. Bedd Gelert
    20/12/2009 at 9:40 pm

    Baroness Murphy,

    Can I just play devil’s advocate with a rather simplistic analogy. One could choose where along the M4 Corridor to live to have a quality of life which bests suits one’s needs and temperament.

    One could live in London, and have the benefit of arts, culture, entertainment, Kew Gardens and the like, but have to tolerate the crime and grime and crowds which come with it.

    One could choose to live in Pembrokeshire and have low crime, little grime, but have to contend with far fewer entertainment opportunities.

    There is a sliding scale of good and bad things as one moves away from London. It is not an exact thermostat. One could live in Swindon and possibly have the worst of all worlds.

    Bristol might offer slightly better culture than Swindon, but considerably more grime than Bath. And Cardiff being another capital might be the happiest medium that one could find.

    AS with so much in life, Assisted Dying is a package deal and much as we might like to pretend that we can have all the benefits without any of the side-effects, wouldn’t we better admitting that as we open the gate on Living Wills and Advance Directives just a little, the consequence is inevitably going to be that some of the downsides tailgate through at the same time ??

    That is not, of course, necessarily a reason not to do it – but it might be more honest for all concerned if we admitted that when calibrating that dial the best we can hope for is a ‘Bath’ or ‘Cardiff’ solution – and that we just aren’t going to be able to keep the unwelcome downsides out of the picture, no matter how hard we try. And it might make it an easier case to sell to the electorate, because one wouldn’t have to row back later when difficult cases do appear in the media ?

    Just a thought – but I would be the first to admit that I am no expert in these matters – but then in matters of ethics and morality, who really is ?? Keep up the good work.

    • Gareth Howell
      21/12/2009 at 1:23 pm

      Taking Bedd’s analogy a little further, can it be that St Peter is waiting patiently at the gate with an open hand, and a smile on hi face, if you die in Westminster but if you die in Llanelly he is shaking his fist and shouting,

      “You blutty heathen! Let the Kiwis win next time. I am a Kiwi, and you won’t get away with it!” (St Peter, in case you didn’t know, Bedd, is a New Zealander)?

      • Bedd Gelert
        21/12/2009 at 11:43 pm

        I didn’t, and given our performance against the All Blacks over the years, is worrying news indeed.

  11. baronesssmurphy
    21/12/2009 at 1:38 pm

    Bedd Gelert, As always you put your point so charmingly it’s tempting to agree. But I think we can, with care and deliberation, set boundaries, decide when a specific act is something which is justified and indeed legal. Rather as the Director of Public Prosecution was able to describe in some depth when an act might be considered worthy of prosecution and when not in cases of assisted suicide, it is possible to reach a consensus about what the majority feel is a morally appropriate act and what is not. I don’t really accept the ‘slippery slope’ argument that once you make something possible the adverse consequences will inevitably slip in behind. That is why most pieces of legislation are backed up by statutory instruments, practice guidelines and often, codes of practice too, which enable a regime of safeguards to protect us from the slippery slope and untoward consequences.

    • Bedd Gelert
      21/12/2009 at 11:58 pm

      I’m not so much suggesting that there has to be a ‘slippery slope’. Using that rather tenuous M4 link, I’m not suggesting that starting off down the road to giving people an element of choice means we will necessarily end up with people practically being pushed into against their will, and you end up in Wales without realising it.

      Merely that people making these decisions have a bit of an understanding that greater freedom of choice for the individual may carry some greater risks. So one should proceed with care when legislating so that the inevitable downsides can be assessed before any further legislative decisions.

      Just because ‘assisted dying’ carries some unwelcome problems is not necessarily reason not to do it if the benefits to society as a whole hugely outweigh the risks – merely that we might need to get to know our new town, far out from the London ‘status quo’ before venturing even further and finding it is not to our liking to be so far from the ‘comfort zone’ of the metropolis.

      Since as with life, once one has left the capital it may not be the easiest thing to return.

  12. Gareth Howell
    21/12/2009 at 2:11 pm

    Reading and Swindon are purgatory. You look up to Westminster and you see graffitti scrawled saying,

    “Assisted dying! Assisted dying! No extra charge! All on the NHS!”

    and you look down to Llanelly and Pembrokeshire and see,

    “Leave us alone! Leave us alone!We know when it’s time to go!”

    and you become so hopelessly confused by London,Heaven, that when you see St Peter with his hand extended in welcome,and a smile on his face, you decide not to take advantage of this petty exercise in heavenly consumerism and you try to do it yourself.

    The net effect is that you end up back in purgatory, on a section of the mental health act, all the more determined to make a better go of it next time.

    You have forgotten all about the religious exhortation of West Wales, that it is best to wait in a queue until your number is up, and not make a fuss about it.

    This is the whole purpose of the line out in Rugby football. You form a queue; (in fact you form two in case there has been a mistake of some sort) you wait for your number to be shouted, and you jump for joy,saying,

    “It’s my number! It’s my number! My number is up.”

    Then you catch a ball, quite by chance, and you know you are in….. Heaven.

    In fact you can be quite certain that you are in heaven because there is an Irishman by the side of the pitch called Coach (or Baroness Murphy) saying how horrified she is at the handling of the laws. That Bedd Gelert, (and I know you are a fictitious Welshman) is how you know the coach is St.Peter,or Baroness Murphy, waiting at the gates, for you to be cheered home.

  13. 23/12/2009 at 12:26 pm

    “Does anyone really believe that drinking anti-freeze and the taking yourself off to an A&E room waving a so-called ‘living will’ is the act of a person who wants to die?”

    Perhaps I am alone here, but I will at least put my X in the “yes, it certainly seems that way” box.

    I don’t dispute that the young lady in question sounds disturbed, but I don’t see how one can say she sounds so disturbed as to not be capable of forming judgements. If we assume that the right to suicide is to be accepted, then presumably we have to accept that the right will encompass people who feel mental distress and inability to cope with life, as well as those suffering from merely physical pain.

    It is easy to say that the doctors are to blame for enabling this person to end her own life, but fundamentally if society in general cannot comfort these people enough then placing the burden on them to make the up or down call is hardly fair. The problem needs to be solved well before it ever reaches the emergency room.

    Indeed, I would say the call was [i]arguably[/i] correct here (although not necessarily so). Ms Wooltorton intended to commit suicide, and picked a painful way of doing so. She asked the doctors to manage her self-inflicted pain, but not to save her life, apparently safe in the knowledge that the law gave her the right to do that. Had the doctors kept her alive, what guarantees would they have that she would not repeat the attempt but, next time, without the call to 999? Lives saved nil, human suffering significantly increased.

    Whether this was the right call or not, I am not possibly qualified to say. But I will not by any means condemn the doctors for making a reasonable judgement call in a difficult case at the end of a young girl’s troubled life. It was not their job to prevent her suicide.

    • 23/12/2009 at 12:27 pm

      Dear mods, please fix my incorrect tags for me! Many thanks (also, this message can be deleted).

    • Gareth Howell
      24/12/2009 at 7:21 pm

      For me the questions are did they save her kidneys, or did they not save her, or did they succeed in both?

      Did they allow the kidney failure to progress
      whilst giving her pain killers, or did they remove the kidneys before the anti freeze got anywhere near them to prevent their failing?

      That may be the nub of the matter. I am not sure.

      Whatever happened, she succeeded in her ambition, but how?

  14. Gareth Howell
    24/12/2009 at 7:36 pm

    “strong supporter of Assisted Dying for the Terminally ill when the decision is made in the setting of full mental competence in someone free of any diagnosable mental disorder2”

    “Her so called Living Will was invalid, a travesty, made in the setting of a long standing mental disorder.”

    Yes noble baroness there is the world of difference between the two, and no heads should be beaten about, to highlight the one at the expense of the other.

    I wonder what precisely her living will said, and radically at what point they declared her dead.

    If they accepted the living will, did they also accept that her organs would be ‘harvested’ if they possibly could?

    At precisely what point of ingestion was she declared officially dead?

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