UK
Myodil arachnoiditis claims settled out of court
of the injury caused failure to aspirate Myodil it would have been necessary to rely heavily on expert medical evidence and the interpretation of, sometimes, incomplete medical records (in particular the To prove the
:
cases several) from the 1960s. In 1987 On July 31, settlement in the sum of C7 million with reasonable provision for Myodil was withdrawn, allegedly because it of but no admission had been "superseded". By then it was little costs, liability by Glaxo Laboratories Ltd, was accepted by used in the UK. The plaintiffs claimed that Glaxo had lawyers acting for the 426 plaintiffs : who claimed they had suffered from carried out insufficient research into the crippling arachnoiditis caused by the safety of the product, and had failed to contrast agent iophendylate (Myodil). The provide adequate warnings of the risks and of the need to aspirate after the diagtrial, which was supposed to start in October this year and had been postponed sevnostic procedure. The action was poteneral times since 1994, might have run up tially complex because it spanned so long costs of several million pounds. Since a period, with variance in imputed or almost all the plaintiffs were legally aided, actual knowledge. Another difficulty was Glaxo could not have recovered its own that the plaintiffs had pre-existing back costs even if it had succeeded on all or pain, some with congenital disability. some of the claims, which spanned some Many had undergone spinal surgery. The 20 years. The claims alleged that arachcriteria were strict-of some 3600 cases often with serious : noiditis, investigated only 426 were selected for very disability, the group action. was caused by Myodil injections (in some :
Irish
Supreme Court approves "right-to-die"
The Catholic Church, pro-life groups, and sections of the medical profession in Ireland have expressed much concern a landmark ruling of the Irish over Supreme Court that a life-support feeding system should be withdrawn from a 45-year-old brain-damaged woman. In a four-to-one majority decision, the Court ruled that the woman, who has been in a near-permanent vegetative state for the past 23 years, should be allowed to die. The woman’s family had earlier been granted leave by the High Court to remove the feeding tube but this judgment had been appealed by the Irish Attorney General and the institution where she is being treated (see Lancet : 1995; 345: 1296). The woman, who has not been named, originally suffered serious brain damage while undergoing a minor gynaecological operation in 1972. : The Irish Chief Justice, Mr Justice Liam Hamilton, said that the issue in the case was not about euthanasia and not : about putting down the old and the infirm, the mentally defective, or the : physically infirm. The Chief Justice said : that the treatment of the woman involved : feeding through a gastrostomy tube. Such: : treatment was intrusive, constituted an interference with the integrity of her body, and could not be regarded as : normal means of nourishment. "It is : quite clear from the evidence that without : the benefit of nourishment provided by the treatment being afforded her she : would die within a short period of time : and in this regard, she must be regarded : as terminally ill", he said. The Chief : : "As the is added: of Justice process dying part and an ultimate consequence of life, : the right to life necessarily implies the : right to have nature take its course and to die a natural death and, unless the individual so wishes, not to have life
i
368
extent
by injection and
contemporaneous radiographs). The settlement gives an average award of some C16 000. Claims have been assessed on a points system that takes into account individual claims for pain and suffering and loss of amenity. Since most of the plaintiffs are in severe pain and have major disability-and since they have effectively received no compensation for loss of earnings-many are disappointed with the awards but nearly all have accepted the offer on the advice of their lawyers. I
was
instructed as counsel in this claim.
on
Diana Brahams
Parents seek right to allow boy in UK to die
case
artificially maintained by the provision of by abnormal artificial On July 31,
nourishment,
which have no curative effect and which is intended merely to prolong life". : However, in a minority dissenting ruling, Mr Justice Seamus Egan said that the inevitable result of the removal of the gastrostomy tube would be to kill another human being. He said that this was not a case where the woman had no cognitive function. Such function was present, he stated, however minimal and however close to a permanent vegetative state the means
:
woman was.
After the Supreme Court ruling, the Irish Medical Council said that it would have to draw up new guidelines for doctors faced with patients in a partial or
fully vegetative
state.
;
The Catholic Church in Ireland also expressed worry at the Court ruling. The Archbishop of Dublin, Dr Desmond Connell, said that the ruling gave rise to grave concern of both a moral and social nature. The Fellowship of Catholic Scholars said that the Irish test case "outstripped" the Nazis and provided the
State with a constitutionally correct alibi: : for euthanasia in Ireland. A group called "Doctors for Life", which has campaigned against the introduction of abortion into Ireland, attacked the contention of some of the judges that the woman was suffering from a terminal illness. It argued that a condition could not be terminal if the mere provision of nutrition and ordinary care was sufficient to maintain life. However, the Supreme Court judgment was welcomed by the Irish Council for Civil Liberties. The woman is now expected to be moved shortly to another hospital where the feeding tube will be removed. Martin Wall
behalf of the
plaintiffs
a boy in the UK was made a ward of court, the first step by which the case for approving the withdrawal of his life-sustaining treatment can be heard and proceed. He was severely brain damaged in utero. He is 22 months old and cannot hear or speak and has been fed since birth through a gastrostomy tube. He is in constant pain unless sedated, cries inconsolably, and has frequent seizures but cannot be cuddled because of muscle spasm when touched. His parents want feeding to be stopped so that he can die under sedation. He was made a ward because his doctors felt unable to withdraw feeding without court sanction. (Perhaps, in the absence of court sanction, they feared a prosecution for homicide.) The President of the Family Division, Sir Stephen Brown, said that he hoped the wardship and the involvement of the court would help to alleviate the heavy burden of responsibility that the parents shared with the health service. From now on, any change to the boy’s treatment will have to be approved by the courts. It is now technically lawful to abort a fetus up to term on the grounds that it is likely to be seriously handicapped. But, once the child is born, even if with a hopeless outlook, there can be no claim for "wrongful birth" either under common law or by statute. British Law assumes, prima facie at least, that the very existence of life, however negative or negligible its quality, is preferable to no existence. However, the law is gradually taking official note of practical experience, as in the Bland case (see Lancet 1993; 341: 428), which allows withdrawal of lifesustaining treatment from patients in a
persistent vegetative Diana Brahams
state.