Table Of ContentA Good deAth?
To family and friends for their ongoing support
A Good death?
Law and ethics in Practice
Edited by
Lynn hAGGer
University of Sheffield, UK
Simon WoodS
University of Newcastle, UK
© Lynn hagger and Simon Woods 2013
All rights reserved. no part of this publication may be reproduced, stored in a retrieval
system or transmitted in any form or by any means, electronic, mechanical, photocopying,
recording or otherwise without the prior permission of the publisher.
Lynn hagger and Simon Woods have asserted their right under the Copyright, designs and
Patents Act, 1988, to be identified as the editors of this work.
Published by
Ashgate Publishing Limited Ashgate Publishing Company
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British Library Cataloguing in Publication Data
A good death? : law and ethics in practice. -- (medical law
and ethics)
1. right to die. 2. right to die--Law and legislation.
3. terminal care. 4. terminal care--Law and legislation.
5. Palliative treatment--moral and ethical aspects.
i. Series ii. hagger, Lynn. iii. Woods, Simon, 1961-
344'.04197-dc23
Library of Congress Cataloging-in-Publication Data
hagger, Lynn.
A good death? : law and ethics in practice / By Lynn hagger and Simon Woods.
p. cm.
includes bibliographical references and index.
iSBn 978-1-4094-2089-7 (hardback) -- iSBn 978-1-4094-2090-3 (ebook) 1. terminal
care--Law and legislation--Great Britain. 2. Palliative treatment--Great Britain. 3.
terminal care--moral and ethical aspects. 4. medical ethics--Great Britain. i. Woods,
Simon, 1961- ii. title.
Kd3410.e88h34 2012
344.4104'197--dc23
2012022044
iSBn 9781409420897 (hbk)
iSBn 9781409420903 (ebk – PdF)
iSBn 9781409472551 (ebk – ePUB)
III
Printed and bound in Great Britain by the
mPG Books Group, UK.
Contents
Notes on Contributors vii
Foreword xi
Preface xiii
1 Introduction 1
Lynn Hagger and Simon Woods
2 The Right to Demand Treatment or Death 9
James Munby
3 Redefining Death? 23
Daniele Bryden
4 Defining Personhood to Death 41
John Erik Troyer
5 Suicide Centres: A Reasonable Requirement
or a Step Too Far? 55
Lynn Hagger and Christoph Rehmann-Sutter
6 Health Economics: Decisions and
Choices at the End of Life 83
Vincent Kirkbride
7 The ‘Good Death’, Palliative Care
and End of Life Ethics 103
Simon Woods
8 Children, Law and a Good Death 123
Lynn Hagger
9 Practical Realities of Decision-making
Relating to End of Life Care 151
Jeff Perring
vi A Good Death?
10 The Story of Isabel 167
Sabine Vanacker
Index 177
Notes on Contributors
Daniele Bryden qualified in medicine from the University of Manchester. Her
postgraduate training was in intensive care medicine and anaesthesia, during which
she was an Intensive Care Society Travelling Fellow, undertaking research at the
North West Injury Research Centre. In 2001, she moved to Sheffield Teaching NHS
Foundation Trust where she works as a Consultant in Intensive Care Medicine
and Anaesthesia. Daniele sits on a NICE Technology Appraisal Committee, is the
national Critical Care Tutor (Anaesthetics) for the Royal College of Surgeons of
England and is an editorial board member of the British Journal of Anaesthesia. In
2004 she completed a qualifying LLB (Hons) from the Open University fulfilling
a long-term interest in the law and its operation within medicine. She completed
a Master’s in Medical Law and Ethics at the University of Glasgow in 2008, and
concentrates her non-clinical time on areas where her legal and ethical knowledge
is utilized such as doctors in training, resource utilization within the NHS and
providing education and support regarding end of life care to anaesthetic and
intensive care unit professionals. Daniele also teaches legal aspects of medical
practice to undergraduate medical and law students at the University of Sheffield.
Lynn Hagger became a legal academic with lectureships at the Universities of
Manchester, Liverpool and currently Sheffield after careers in social work and
legal practice. She has taught administrative/public law, contract, environmental
and European law but now teaches torts and specializes in medical law and ethics.
In parallel with her academic career, she has been involved in the NHS for over
20 years, mostly as a non-executive director of acute hospital boards. She was
Chairperson of Sheffield Children’s NHS Foundation Trust for nine years and
currently serves as a Non-executive Director at Leeds Teaching NHS Trust. This
has provided opportunities to focus her research on how the law might strengthen
the rights of the individual citizen in the field of health care law and policy. She
is part of a network of multidisciplinary research collaborators in the national and
international context.
Vincent Kirkbride qualified in 1988 and was trained in paediatrics in London,
Canada and Australia. He was a Medical Research Council lecturer with the
Perinatal Brain Research Group at University College Hospital in London,
a Perinatal Fellow at the Hospital for Sick Children in Toronto, and a Senior
Neonatal Fellow at Monash Medical Centre, affiliated to the University of
Monash, in Melbourne. He was appointed as a Consultant in Neonatal Medicine
at Royal Hallamshire Hospital in Sheffield (now the Sheffield Teaching NHS
viii A Good Death?
Foundation Trust) in 1997. He has postgraduate qualifications in epidemiology,
business management and health care ethics and law. He has been a member of the
Appraisals Committee of the National Institute for Health and Clinical Excellence
since 2007. He is also Chair of the Sheffield Teaching Hospitals NHS Foundation
Trust’s Clinical Ethics Committee. He is interested in the ethics and economics of
intensive care, and also neonatal transplantation and end of life care.
James Munby was called to the Bar in 1971 and made a Queen’s Counsel in 1988.
In 2000 he was appointed a Judge of the High Court, sitting in both the Family
Division and the Administrative Court. In 2009 he was appointed Chairman of the
Law Commission and a Lord Justice of Appeal.
Jeff Perring is a Director of the Paediatric Critical Care Unit and a consultant
paediatric intensivist at the Sheffield Children’s NHS Foundation Trust. Following
his medical qualification at the University of Liverpool, Jeff trained in anaesthesia
within Merseyside and the North-East of England. He took time out during this
training to focus on neonatology, researching into the metabolism of premature
infants before specializing in paediatric intensive care. He became a consultant at
Sheffield Children’s Hospital in 2002. In 2007, he completed an MA in Healthcare
Ethics and Law at the University of Manchester with a dissertation entitled ‘Gross
negligence manslaughter and understanding medical disasters’.
Christoph Rehmann-Sutter is Professor of Theory and Ethics in the Biosciences
at the University of Lübeck in Germany and Visiting Professor at the BIOS Centre
(a centre for the study of bioscience, biomedicine, biotechnology and society)
at the London School of Economics. After training in molecular biology at the
Biozentrum Basel, he studied philosophy and sociology in Basel, Freiburg i.Brsg.
and Darmstadt, where he obtained his PhD in 1995. Between 1996 and 2009,
Christoph was Head of the Unit of Ethics in the Biosciences at the University of
Basel in Switzerland, first as Assistant Professor from 2000 and then as Professor
of Philosophy from 2007. He was appointed by the Swiss government as Chair
of the Swiss National Advisory Commission on Biomedical Ethics in 2001 and
served until 2009. His research focuses on phenomenological and hermeneutic
methodology for bioethics, genomics, synthetic biology, hematopoietic stem cell
donation by children to siblings and end of life issues.
John Erik Troyer is the Deputy Director and Research Council’s United Kingdom
Academic Fellow in the Centre for Death and Society at the University of Bath. He
received his doctorate from the University of Minnesota in Comparative Studies
in Discourse and Society and began working at the University of Bath’s Centre
for Death and Society in 2008. He is a co-founder of the Death Reference Desk
website (www.deathreferencedesk.org) and his first book, Technologies of the
Human Corpse, will be published by the University of North Carolina Press in
spring 2012.
Notes on Contributors ix
Sabine Vanacker is a lecturer in English at the University of Hull. Her research
and teaching interests centre on twentieth-century literature, with a particular
interest in crime fiction, the literature of migration and women’s writing. She has
published on Agatha Christie, Sara Paretsky, Patricia Cornwell and Sue Grafton,
and is currently preparing The Crime Fiction of P.D. James: Death and the
Melancholic Detective, for Palgrave. With Dr Catherine Wynne she is co-editing
a critical collection, The Cultural Afterlives of Arthur Conan Doyle and Sherlock
Holmes: Representations Across the Media, also for Palgrave. She is married to
David Kelly, an IT professional; their daughter Isabel Vanacker-Kelly suffered
from Tay-Sachs Disease and died in 2004, aged four.
Simon Woods is a senior lecturer and Co-Director at the Policy, Ethics and Life
Sciences Research Centre (PEALS), University of Newcastle (UK). PEALS is an
ethics ‘think tank’ involved in research, teaching and public engagement on the
ethical and social implications of the life sciences and medical ethics. Simon spent
ten years as a clinical cancer nurse and holds Bachelor and Doctoral degrees in
philosophy. He is a member of several national and international ethics committees
and provides training to members of such committees. Simon is involved in
empirical and conceptual research in bioethics and publishes on a range of issues
including those concerning the end of life.
