The High Court challenge in Ireland on the constitutionality and human rights compatibility of the country’s ban on assisted suicide has found in favour of the existing law, Key to the judgment (found here) was the finding that the ban did not amount to a disproportionate interference with personal autonomy. Also of interest were the comments that unlike with UK laws, the Irish Director of Prosecutions would not be able to change the law merely by changing guidelines in regard to prosecution – as this would result in the law not being enforced.
… and now for something completely different. Two recent articles in the Journal of Medical Ethics have presented a novel suggestion to aid in the preservation of organs for donation via elective non therapeutic ventilation (“EV”).
We are all aware of the use of ventilation when somebody is unable to sustain their own breathing within an intensive care setting, however EV differs significantly and is performed when a person is either on their way toward irretrievable brain death (but still capable of breathing) or as soon as possible after formal declaration of death.
This is an ‘elective’ procedure because it requires the patients full consent before any decrease in cognitive capacity or death.
The many ethical conundrums raised by this procedure include:
- ensuring full consent of the patient;
- the risk of the patient surviving in an unacceptably bad state;
- the possibility of changing our perception of organ donation and care in dying;
- the moral distress potentially caused to staff involved;
- the dilemma between the duty to respect a dying patient’s autonomy and the duty not to harm a patient; and
- the possible harm caused to families/caregivers by undertaking the procedure.
**If you would like to see more articles here of a Medico-legal / Medical Ethics genre, let me know!