Academic journal article The Hastings Center Report

The Clinician versus the Crown

Academic journal article The Hastings Center Report

The Clinician versus the Crown

Article excerpt

A recent court case in Britain has brought the issue of euthanasia back to the forefront of public debate there. In September 1992 Dr. Nigel Cox, a respected hospital specialist in rheumatology, was convicted of attempted murder for ending the life of a patient, Mrs. Lillian Boyes. For many years he had treated her for severe rheumatoid arthritis, which she had borne with courage and resilience until in August 1991 she was admitted once more to hospital with a severe relapse that caused her intense pain. Treatment was ineffective in controlling her symptoms, and she developed a variety of complications, including ulcers and abscesses on her arms and legs, fractured vertebrae, and a deeply penetrating rectal sore.

Eventually she decided she wanted no more active measures and requested pain relief alone. However, when large doses of opiates and sedatives failed to relieve her pain, by now so severe that she howled like a dog when touched, she asked Dr. Cox to end her life. At first he declined, but after she repeated the request, and in the face of her unrelieved distress, he administered intravenous potassium chloride and she died shortly after. He recorded his actions in her chart and certified the cause of death as bronchopneumonia. A senior nurse who later read the chart was disturbed by what she saw and, after deliberating for several days, informed her manager, who called in the police. Dr. Cox was suspended from duty and charged, but only with the lesser crime of attempted murder, because by this time Mrs. Boyes's body had been cremated and there was no definitive evidence of the cause of her death. Had there been such evidence, Dr. Cox would have faced a charge of murder and, if convicted, a mandatory sentence of life imprisonment. The trial was conducted amid intense publicity, with lobbyists for and against the legalization of euthanasia determined to make what they could of the case.

The defense argued that, in acting as he did, Dr. Cox's primary intention had been to kill the pain and not the patient. After seeking clarification on the role of intention in attempted murder, the jury, amid scenes of great emotion, convicted Dr. Cox by a majority verdict, and the judge subsequently passed a suspended prison sentence of one year. …

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