The Gazette 1995

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GAZETTE
DOUBLE JOBBING SOLICITOR!
"Double Jobbing Solicitor" - Irish
solicitor while on vacation in Florida
acts as Sales Executive on behalf of
her cousins, the Lynch sisters from
Ballydehob, Co. Cork, who carry on a
most hospitable hostelry on "Long
Boat Quay" a sumptuous archipelago
on the west coast of Florida,
overlooking the Gulf of Mexico.
Patrons and potential patrons can rest
assured that solicitor, Ms. Lynch did
not indulge in cooking any of the
fare, nor tamper with the cuisine in
any way, but merely used her
solicitors experience to attract the
casual passer-by!
MARCH 1995
The Inaugural Burren
Law School 1995
Convened by Brian Sheridan,
Solicitor in association with
The Clare Law Association
at
Newtown Castle
Ballyvaughan, Co. Clare
Friday, 31 st March to Sunday
2nd April
'Crime and Punishment - A
Brehon & 20th Century
Perspective'
A stimulating weekend of lectures,
debate and fun.
Speakers to include:
Joan Burton TD, Minister of State;
Eamonn Barnes, DPP; Prof.
William Duncan, TCD; Dr.
Muireann Ní Bhrolcháin,
Maynooth University.
For further infornmation please
telephone (065) 77200 or
(01) 2692126
61. In re Eichner NYS 2d (App Div) 1980.
62. The decision rests on an assessment of the
patient s ultimate condition. There are two
possible results of discontinuance; either
the patient breathes spontaneously and
survives, or they die as a result of cardio-
respitory failure. The decision is essentially
a clinical one which the doctor makes on
the basis of what the ventilation treatment
can achieve for the patient. If ventilation
constitutes non-productive treatment, then
it can be discontinued. See generally Mason
J.K. op. cit. at 46-7.
63. Airedale NHS Trust v Bland [1993] 1 All
E.R. 821; Frenchay Healthcare NHS Trust
v S |I994] 2 All E.R. 803.
64. BMA Discussion Paper on Treatment of
Patients in Persistent Vegetative State,
September 1992, quoted in Bland, fn 63 at
871.
65. R v Malcherek, R v Steel [ 19811 WLR 690.
66. John F. Kennedy Memorial Hospital v
Bludwortli 452 So 2d 921 (Fla. 1984).
67. Mason J.K. op. cit. cites as examples
Relman A.S. The Saikewicz decision:
Judges as physicians' (1978) 298 New Engl
J Med 508; Dunea G. 'When to stop
treatment' (1983) 287Brit Med J 1056. At
the time of writing, November 1993, there
have been no such applications in the
courts as in the Bland case, fn 63.
68. Lappe M. 'Dying while living: A critique of
allowing to die legislation' (1978) 4J Med
Ethics195.
69. 'Butterworths Medico-Legal Encyclopedia'
(1987) at 553. Our emphasis.
70. Editorial The Lancet341(1993) 1123.
71. supra at 1124. See also the article by
Ezekiel Emanuel in the'Lancet', Jan 16,
1988 p. 106.
72. See Kjellstrand C.M. 'Who should decide
about your death?' JAMA 267 (1992) 103
where a survey showed that 70% of patients
interviewed wished to discuss the issue
with their doctor, but only 6% had done so.
In Kohn et al 'Life Prolongation: Views of
Elderly Outpatients and Health Care
Professionals' JAGS 36( 1988)840 it was
found that patients believed that the doctor
should initiate discussion, but doctors were
reluctant to do so for fear of unnecessarily
alarming the patient.
73. Stewart et al 'Resuscitation decisions in a
general hospital' BMJ 30()( 1990)785.
74. In one UK survey 1 1% of patients for
whom resuscitation was attempted survived
to discharge. Keating 'Exclusion from
resuscitation' 82( 1989) JRSM 402.
75. Torian et al 'Decisions for and against
Resuscitation in an acute Geriatric Medical
Unit' 152(1992) Arch Intern Med 561. See
also Murphy et al The Influence of the
Probability of Survival on Patients'
Preferences' 330 (1994) N Engl J Med 545
where a study of elderly patients' attitudes
to CPR after their doctors had informed
them of the possible outcomes of such
treatment showed that, whilst 41% had
opted for CPR before learning of the
probability of survival, this was reduced to
22% after such discussions.
76. Some research shows that surrogates tend
to display a greater reluctance to withdraw
treatment than the patients would
themselves; Uhlmann et al "Physicians and
Spouses' Predictions of Elderly Patients'
Resuscitation Preferences' 43( 1988) J of
Gerontology 115. Other research indicated
that where decisions were made by
surrogates, a greater number of patients
were classified as DNR; Luce P.
'Cardiopulmonary Resuscitation in the
Elderly' 47 (1993) BJCP 285.
77. Emanuel The Economics of Dying' (1994)
N Engl J Med.
78. Luce P. toe. cit.
79. 'Variability in Physicians decisions on
caring for chronically ill elderly patients:
an international study' 144(1991) Can Med
Assoc J 1133.
80. In a survey of doctor's attitudes towards
such documents, it was demonstrated that
the single most important influence on a
doctor's decision to withhold treatment was
the patient's self reported wishes; Miller et
al 'Factors Influencing Physicians in
receiving in-hospital CPR' 153( 1993) Arc/i
Intern Med 1999. In an American nursing
home where 76% of the residents
completed advance directives, one year
after implementation it was found that
deaths in the home had increased and
deaths in hospital had decreased, along
with a decrease in the mean length of
hospital stays.
81. Kjellstrand C.M.Inc. cit.
82. 'Middlemarch' (ed. Harvey W.J. 1965) at
186.
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