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Now crash victims get right to die
Sophie Goodchild and Anna Davis17.04.09
PARAMEDICS are being ordered not to resuscitate patients who want to die after a serious accident, the Standard can reveal today.
The guidance from London ambulance chiefs has government backing. But it will fuel the debate over how far medical staff should go in prolonging life.
The London Ambulance Service says new laws strengthening patients' rights mean paramedics have a duty to respect people's wishes — even if this means allowing them to die.
The new system allows otherwise healthy people to register their “death wishes” in advance on a secure database. It was originally set up by the London Ambulance Service to meet the needs of terminally ill patients but it has now been expanded to include end-of-life care requests from any member of the public.
Doctors and campaigners today warned the system could be open to abuse.
Dr Tony Calland, head of the British Medical Association's ethics committee, said: “The risk for healthy people who sign up to this database is they could be in an accident in 30 years time and have changed their mind.”
Andrew Harrop, from Age Concern and Help the Aged, said: “When making such an important and personal decision, people must receive all the relevant information. It's paramount that public bodies always satisfy themselves that people are making an informed choice and are always vigilant for potential abuse.”
This is understood to be the first time an ambulance service has registered the wishes of healthy people who do not want to live if their quality of life is seriously impaired.
It comes in response to guidance issued by the NHS in October 2007 about how to deal with terminally ill patients who are covered by the LAS system.
The database is used by control room staff who brief crews when they receive an emergency call. David Whitmore, who set up the database, told the Standard the guidance helped prevent difficult situations where a relative asks paramedics to revive someone against their will. “Do not resuscitate” cases are among the total of 1,624 people already registered with the LAS.
Mr Whitmore, a senior medical adviser with the LAS, said: “A paramedic's ethos is to save a patient's life if they can. But it's also about respecting a patient's wishes and we must legally go with that.”
Ambulance chiefs say they expect the end-of-life wishes of everyone in London to be lodged on the database eventually. This includes advance decisions from “right to die” campaigners.
Mr Whitmore said it was only “a matter of time” before they received such a request. He said: “We would obviously not do anything to help them die. But we are obliged to register their wishes if these have been agreed legally.”
The database carries the name and address of anyone who is registered so crash victims would need additional identification. This could include a special wristband which the LAS issues to anyone who signs up.
People register on the database by contacting their GP who then sends their details to the LAS. They also have to fill in a “do not resuscitate” form.
The Department of Health emphasised that such advance decisions would have to be made in writing and be legally watertight.
Patients' rights
THE Mental Capacity Act of 2007 increased the rights of people to control their own medical treatment. It applies to anyone able to make their own decisions and medics are obliged to respect these decisions as long as they are in writing and legally water-tight. Actively helping people to kill themselves is still a crime.
Reader views (23)
I feel it is about time people had the right to chose. I will die one day and when my time comes I do not want some doctor or paramedic reviving me. What gives them the right to make me live again when I'm dead? I'm having a living will drawn up that states 'Do Not resuscitate' and I'm having it tattooed on my chest. But I bet if I had an accident, no one would take it into consideration and they would bring me back to life anyway. In my opinion its wrong to make someone live after they die.
- Wendy, Wolverhampton UK
This Do Not Resucitate thing is just another form of Euthansia, only this form is approved by the government!
- Seb, london
My bigger concern would be people abusing the system so they can die freely - fine, but how many other people accidentally got injured in the process?
- Marianne, SW France
Many a time I have said; I wish I was dead; I just hope nobody hears or believes me; especially those in Ambulances, or Hospitals.
- Mickyinlondon, london
This may cut cost to the healthcare system by reducing the number of people who receive expensive treatment at the time of an emergency and afterwards.
- Ken, Tacoma, Washington, USA
I suppose this is for people who fear they might suffer spinal cord injury and the like and think they wouldn't want to spend the rest of their lives on a ventilator or in a wheelchair. Paramedics on the scene are there to stabilize and transport. They can't give a prognosis - they don't have the equipment and it's not their function. They're supposed to make the decision whether an unconscious person only has a concussion and will recover, or has suffered irreparable brain damage? Even neurologists with lots of time and experience and specialized equipment sometimes get that wrong.
- Laura, Florida, USA
You can still change your mind even if wearing a wrist band. Perhaps the person changed their mind internally before the accident, or may have changed their mind post-accident but would be unable to communicate it. What then? Would the patient's wishes really be being respected, or is the whole thing just an exercise in championing death over life? And should a paramedic, upon arriving at an accident, really be spending time first checking if someone is on some database and checking if their wristband is all in order? Such time shouldn't be wasted on such things, but on saving the life of the injured on the floor.
- Richard, London
Best to avoid being knocked down then!
- Sheila, london uk
Call me cynical, but what starts out as "patient's rights" could quickly turn into a way to dispose of paramedics all together. That would save the NHS some money.
- Erica, US
so if the paramedics is called out to an accident and sees that the crash victim is registered to die does he just walk away? or what about if there's a similar name like "john smith"there's thousands of them
- Kadir, London
"the risk" is that they change their mind? Well then its THEIR responsibility to change their declaration!
And frankly, if someone in their, oh lets see, 40s or 50s makes such a declaration - they are thinking far more clearly than 30 years later.
Nanny simply cannot do it all.
- Trunk, US
Perhaps I have misunderstood this article, but it plainy says that "The database carries the name and address of anyone who is registered so crash victims would need additional identification. This could include a special wristband which the LAS issues to anyone who signs up."
Would it not therefore be possible to say that the person could only be allowed to die if they were wearing said wristband? If so, then people who have changed their minds would not be wearing the wristband, and therefore this would not be applicable?
- Debra, London, UK
Could the same 'wish to die naturally' be applied to hunger strikers as well? It would soon putan end to their pathetic attempts at empotional blackmail.
- Blind Pugh, Woking, UK
I think it's a great idea as long as all the necessary precautions and diagnostics are that you would not survive or you would be in a vegetative state.
The downside to this is that there could be a risk of not saving you if they could see more potential for organ donation especially to people paying for private operations of this nature on the black market.
- Don'T Want To Be A Veggie, London
This is typical of current society that champions death over life. If someone registers a desire to die if involved in an accident what would happen if they changed their mind in the meantime? Their wish would then be to live, not die- and an ambulance crew would just leave them to die, with full backing of the Government? That is sick. The default setting of health professionals/paramedics should be saving life, not just leaving a person to die as if they were a dog. And don't give this tripe about if you're a 'card carrying' whatever- anybody can change their mind, and you can hardly ask someone if they have or not in the aftermath of a serious accident. No, paramedics save life, and if the person who is saved wishes to take their own life at a later date there's nothing stopping them. You could almost guarantee though that, once saved, most 'card carriers' wouldn't take their life when they had the chance- I wonder why?
- Richard, London
Are we talking about attempted suicide here? If not, I can't understand the mentality of someone who decides in advance that they don't want someone to try to save their life after an accident. That said, I do think that their decision should be respected. It's their life, and no-one else's.
- Nigel, London
Ab- London
your comment clearly indicates that you did not read the article...
this system, where healthy people register their "death wishes" in advance on a secure database
is not a decision taken at the scene of the incident...
- Martin_Clerkenwell, london
"This is akin to finishing off a horse who sustained a bad injury "
No it isn't!
- Paul, London
If true, this is shocking news, and criminal!!! "
Mo it isn't. If you have a card saying don't resuscitate me, then they should leave victims alone. And if you say it to the paramedics then they should do the same
- Keith Price, Luton, England
How would someone with head injuries know if they want to die or not, they could be just unconcious for the period of a few days, I could never concieve of someone in an accident saying calmly "Please leave me I want to die"
My god who ever thought this one up has no comprehension of how dying people fight hard till their last breath to live! yes there are a very few who would take the option of going before thier time but they are in a very very tiny minority - I think I will where a "save me" bracelet in future.
- Pat, sussex
If true, this is shocking news, and criminal!!!
This is akin to finishing off a horse who sustained a bad injury making it unfit to serve!
I am totally against it!
- Nabil H, London, UK
I don't think anyone who has just suffered serious injuries as a result of an accident will be in a fit state to make a rational decision.
- Ab, london
But aided suicide for the terminally ill is still illegal in the UK. I cannot see difference between paramedics letting accident victims die at the victims request, and aided suicide if the terminally ill patient requests it.
- Dom, London
