The Gazette 1995

GAZETTE

treatment", but (per Blayney J) "that normal food and drink would never be categorised as medical treatment"; and that, therefore, if the ward could have taken food and drink in the normal way no order to terminate such feeding would have been made. However, the decision related to a patient who was near-PVS but not fully-PVS, and the fact that the ward had a minimum degree of cognition weighed heavily with Egan J in his minority judgment. The fully-PVS patient is able to breathe unaided and the patient's digestion continues to function but such a patient cannot see, hear, taste or smell, is incapable of voluntary movement, cannot speak or communicate in any way and feels no emotion. In the present case, the Supreme Court concluded that the ward appeared to have some small awareness of longstanding nurses but was not at any time able to show any recognition of any member of her family who had visited her regularly over the last 23 years. CJ and O 'Flaherty J carefully distinguished between euthanasia, "which involves positive assistance towards the termination of life" and "the withdrawal of invasive medical treatment in order to allow nature take its course". Two theologians gave evidence in the High Court that the application by the ward's family was a morally acceptable one although a third questions involved. However, all four majority judgments emphasised that the decision was based on the particular facts of the case and that applications of a similar nature in the future would have to be decided on a case by case basis. The majority judgments of Hamilton theologian gave evidence to the contrary - an indication of the complexities of the theological Understandably, considerable comment and analysis, both supportive and critical, have followed in the wake of the Supreme Court decision, not least from members of the medical and nursing professions who are on the front line of the actual treatment of patients such as the ward in this case. The legal kernel of the decision may be summarised as follows;-

1. that in certain circumstances the (ward of court) patient who is fully- PVS or near-PVS may have artificial food and hydration withdrawn by order of court where there is no prospect of improvement, so that the patient can be allowed to die naturally, provided that the court decides that it is the patient's best interests for that to happen; infirm, or the mentally-handicapped, although the dividing line between those categories of patient and a near-PVS patient did not arise for decision in the case; 3. while Lynch J (in the High Court) and Denham J (in her individual Supreme Court judgment) considered possible guidelines which could be followed by the courts in future cases, the overall majority decision did not lay down any such guidelines other than that future decisions would have to be made having regard to the individual facts of each case. Whilst it is the right of any concerned person or body to critically comment on a court decision such as this, the fact remains that the Supreme Court decision in this case constitutes a statement of the law on the issue involved. As a democratic state we profess to abide by the Rule of Law and in doing so to recognise the individual's constitutional right to act, within the law, in accordance with his or her conscience. Insofar as recent media statements of the Medical Council and the Nursing Board (An Bord Altranais) may have done so expressly or impliedly, it seems inappropriate that an individual doctor or nurse, who in conscience feels able to comply with the law as expounded by the Supreme Court, should be threatened with possible disciplinary sanctions for so doing. This sequel to the Supreme Court decision emphasises that the Rule of Law requires that the legal and the moral dimensions of an issue should be clearly distinguished one from the other. • 2. that no such order can be made which might effect the old, the

Apprent i ces Cl ient I n t e r v i ewi ng Compe t i t i on The Law Society will run a Client Interviewing Competition in November 1995, in conjunction with the International Client Counselling Competition and in accordance with their rules and regulations. The winning entrants will be entitled to compete in the International Client Counselling Competition which is I due to be held in Australia in March 1996. Association. Ireland has been successfully represented at the Competition on two occasions. Last year's entrants, Valerie Kennedy and Mairin Stronge performed exceptionally well and were placed second to Australia in the Competition which was held in Florida in March 1995. This was against strong opposition from America, Scotland, England and Wales, Northern Ireland and Canada. I The Irish Competition will be run on the basis of a two member team. Entrance is restricted to apprentices who attended the 35th, 36th, 37th and 38th Professional Courses. The entrance fee per team will be £ 1 0. Í The members of the winning team will each receive a prize of £ 1 , 0 0 0. Of this sum £ 2 0 0 will be paid to them ! personally and £ 8 0 0 will go towards their expenses in competing in the | International Client Counselling | Competition. ! complete the entry form distributed in this Gazette if you want to take part. j ! In the event that there are sufficient i , 1 entrants from either Cork or Gal way, it may be possible to hold regional heats in these areas. • | The closing date for the Competition is Friday 6th October 1995. Please The International Competition is ; affiliated to the International Bar

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