94.Memorandum from Dr Charles O'Donell
Thank you for offering me the opportunity to
express my views regarding the aforementioned Act of Parliament.
As a doctor working in critical care I am frequently
involved in end of life decision-making. This includes withdrawing
artificial ventilation, terminating attempts at cardio-pulmonary
resuscitation and refusing entry into Intensive Care. The proposal
to offer Continuing Power of Attorney to somebody who is not medically
qualified and dealing with the particular case in hand concerns
me greatly. Such a proxy decision maker may be influenced in his
or her decision making process by factors that have little or
no bearing on the overall best interests of the patient.
One commonly meets relatives who are overwhelmed
by the complexity and perceived burden of medical therapies who
may therefore if given the casting vote opt for treatment withdrawal
based (albeit in good faith) on false perceptions of the overall
Sadly what is even more frightening about the
Lasting Power of Attorney proposal is that it naively assumes
that the attorney is incorruptible! If an individual may benefit
financially from a patient's death the true best interests of
the patient are compromised
It is vital that in any just society the law
should protect the most vulnerable as effectively as possible.
A senior clinician taking regard of the valued opinions of other
healthcare professionals and the relatives of the incapacitated
person who is ultimately accountable to the courts is the best
way to achieve this goal.
Undoubtedly, patient autonomy is one of the
important factors to be taken into the equation when making end
of life decisions. It is a paradox that the advocates of this
Act of Parliament see it as a means to protect autonomy whilst
in fact it runs the serious risk of threatening this right for
the most vulnerable members of our society. If the more privileged
members of society, I guess like you and I, have to tolerate a
slightly perceived or indeed actual diminution of our right to
autonomy in order to protect the common good then that is to my
mind true justice.
The common good ie that situation that ensures
the rights of the most vulnerable even at the expense of the more
fortunate should be the guiding maxim of any law relating to the
Once again thank you for the opportunity to
express my view. I hope the draft will be amended accordingly.