Where does the law currently stand on end-of-life care?

Exploring the nuances of assisted dying and euthanasia...
06 February 2024

Interview with 

Imogen Goold, University of Oxford




Any change in the law on assisted dying would require new framework and guidance. But what exactly do the statute books say about what medical professionals can and can’t do when someone nears the end of their life? Chris Smith has been spoke to Imogen Goold, a professor of medical law at the University of Oxford...

Imogen - One first principle is that people can never be compelled to have any form of treatment. So, a person who has the capacity to make their own decisions can always simply say, I don't want to take that medication. That may have all sorts of implications for them, one of them might be that they then die. The other strand to that is doctors can never be compelled to give treatment that they consider not to be in someone's interests or that won't have any efficacy, that won't help them. The doctor may take the view that actually there are no treatments left that they think will do anything that will help the person. In those situations they don't have to treat them. These might be treatments that might have kept someone alive for a little bit longer, but they're extremely onerous, they're very burdensome and unpleasant. The doctor might think, well, on balance, this is just not indicated in this case.

Chris - From what you're saying, I could, as a doctor, elect to withdraw support, I could stop giving food and water to a person if I don't think that's in their best interest. But what I couldn't do then is to give them a massive dose of morphine and stop their heart because, it would amount to the same thing, but I would be actively doing something rather than actively not doing something and, although they amount to the same thing, legally that would be different.

Imogen - Yes, absolutely. You absolutely cannot do something that actively has the intention of ending somebody's life.

Chris - But I can not feed them and starve them to death?

Imogen - Yes. That essentially is the nub of part of the euthanasia and assisted dying debate, is that some people take the view that those two things are actually morally equivalent. In fact, it's worse to withdraw treatment from someone and withdraw support from them so that they die over a long period of time, rather than, as they often frame it, the merciful thing of ending their lives more quickly.

Chris - What do you see as the direction of travel? Do you think that we'll still be having this sort of debate in a decade, or do you think that, probably, we will find ourselves in countries like the UK following countries like Switzerland where there are opportunities for people to go down this path if they elect to do so?

Imogen - So I think we've been trying to travel down this path for at least 25 years. There have been measures brought through parliament multiple times to try to push in that direction and they've all obviously failed because it's such a vexed debate. But what we do see at the moment is that the government has undertaken an inquiry and is continuing to undertake the inquiry into assisted dying, so I think there are steps forward towards either resolving the question in favour of changing the law, or drawing a line under the debate and taking a position that it's been thoroughly investigated and the government will take a position. But, which way it will go I think is very difficult to anticipate at this point, precisely because the arguments are quite finely balanced for and against.


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