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.

The majority judgments of

Hamilton

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

theologian gave evidence to the

contrary - an indication of the

complexities of the theological

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.

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food and hydration withdrawn by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;

2. that no such order can be made

which might effect the old, the

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.

•

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.

The International Competition is

; affiliated to the International Bar

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.

| The closing date for the Competition

is Friday 6th October 1995. Please

complete the entry form distributed in

this Gazette if you want to take part.

! In the event that there are sufficient

entrants from either Cork or Gal way,

it may be possible to hold regional

heats in these areas.

•

222