The law behind ‘living wills’ may need to be changed, says a Government minister, after a depressed woman used one to order doctors not to save her life when she committed suicide.
An inquest ruled that doctors had no choice but to allow Kerrie Wooltorton to die because she arrived at hospital after poisoning herself carrying a note saying she did not want to be saved.
An extract from Miss Wooltorton’s ‘living will’ said: “I am aware that you may think that because I called the ambulance I therefore want treatment, THIS IS NOT THE CASE!
“I do however want to be comfortable as nobody wants to die alone and scared and without going into details there are loads of reasons I do not want to die at home which I realise you will not understand and I apologise for this.
“Please understand that I definitely don’t want any form of ventilation, resuscitation or dialysis. These are my wishes please respect and carry them out.”
Health Secretary Andy Burnham said the news made him “uncomfortable” and that he has been prompted to review the law because living wills were not intended for this purpose.
Miss Wooltorton’s father said the law which allowed his daughter to die makes him ashamed to be English.
The doctors in the case said it would have been considered assault if they had treated the patient against her wishes.
A psychiatrist has raised concerns that this use of living wills could lead to “assisted suicide by the back door”.
Dr Luk Ho, a consultant psychiatrist at the Queen Elizabeth Hospital in King’s Lynn, wrote: “I am well aware of the euthanasia debate about whether it is ethical to use the distinction between ‘act and omission’ to justify withdrawing or withholding life-sustaining treatment in incapacitated terminally ill patients.
“Could professionals be legally permitted in the future to allow patients to commit suicide ‘in their best interests’, because it is the patient who commits the ‘act’ and the professionals merely ‘omit’ treatment?”
Dr Luk also questioned whether Miss Wooltorton’s living will was valid because her history of mental illness and nine previous suicide attempts raised issues over her mental ability to refuse treatment.
“Is is ever possible for a person wishing to commit suicide to have full capacity?” he asked.
However Dr Vivienne Nathanson, Head of Ethics and Science at the British Medical Association said doctors must follow the patient’s wishes when they are competent to make decisions for themselves.
She said: “These situations are extremely difficult for doctors. The Mental Capacity Act has clarified matters because it establishes the legal framework for such decisions.
“However hard doctors find this issue, their ultimate aim is to act in the best interests of their patients, normally this means following competent patients’ wishes.”
Roman Catholic Bishops have warned that doctors who allow suicidal patients to die could be breaking Government guidelines.
A spokesman for the Roman Catholic Bishops’ Conference of England and Wales pointed to Section 9.9 of a code of practice attached the Mental Capacity Act 2005, which includes provision for dealing with people with obvious suicidal intentions.
It warns that medical staff “may have particular concerns about the capacity of someone with a history of suicide attempts or suicidal thoughts who has made an advance decision”.
It goes on: “If the person is clearly suicidal, this may raise questions about their capacity to make an advance decision at the time they made it.”
The spokesman for the Bishops’ Conference said the church was not accusing the doctors in Miss Wooltorton’s case of breaking the law, but called for the code to be made clearer and publicised more widely.
Last month the Director of Public Prosecutions (DPP) in England and Wales issued interim guidance outlining the public interest factors he will consider before deciding to pursue assisted suicide cases.
Keir Starmer QC, who was appointed as DPP earlier this year, made clear that assisted suicide remains illegal.
The new guidance is only an interim policy, and a public consultation on the matter will now run until 16 December.
Kerrie Wooltorton’s ‘living will’ in full
14/09/2007 To whom this may concern
If I come into hospital regarding an overdose or any attempt of my life, I would like for NO life saving treatment to be given. I would appreciate it if you could continue to give medicines to help relieve my discomfort, painkillers, oxygen etc. I would hope these wishes would be carried out without loads of questioning.
Please be assured that I am 100% aware of the consequences of this and the probable outcome of drinking antifreeze, eg death in 95-99% of cases and if I survive then kidney failure, I understand and accept them and will take 100% responsibility for this decision.
I am aware that you may think that because I called the ambulance I therefore want treatment, THIS IS NOT THE CASE! I do however want to be comfortable as nobody wants to die alone and scared and without going into details there are loads of reasons I do not want to die at home which I realise you will not understand and I apologise for this.
Please understand that I definitely don’t want any form of ventilation, resuscitation or dialysis. These are my wishes please respect and carry them out.
Yours sincerely
Kerrie Wooltorton