1. E THICAL DECISION MAKING & A SSISTED SUICIDE : N O EASY ANSWERS Jo Fernandes: Practice Development Nurse Hospice of St Francis June 2012

2. A IMS The law Helpful guidelines / theory Public influences Case studies

3. Current UK law 1961 Suicide Act remains unchanged ↡ Assisting in someone’s suicide = ILLEGAL

4. Policy for Prosecutors in Respect of Cases of Encouraging or Assisting Suicide February 2010

5. “Let me make it clear; only parliament can change the criminal law…. So the critical question I have considered is; what are the circumstances in which it is or is not in the public interest to prosecute a person who assists in another’s suicide” www.telegraph.co.uk 23/09/09

6. 16 FACTORS IN FAVOUR OF PROSECUTION

7. “We are proud of the way we temper justice with mercy” Starmer 09

9. “An act by which the Doctor’s primary intention is to bring about a patient’s death would be unlawful”

10. “it is for the law lords to decide the law of the land”

11. June 2011

12. C ONCLUSION “The commission has concluded that it is possible to devise a legal framework that would set out strictly defined circumstances in which terminally ill people could be assisted to die, while providing upfront safeguards to protect potentially vulnerable people. It must be a matter for parliament to decide on behalf of our society as a whole whether to implement such a framework

13. P UBLIC SUPPORT

14. “Submission to the commission on Assisted dying ” April 2011

15. Reinforces ethos of hospice and palliative care : “intends to neither hasten nor postpone death”

17. N URSES BULLIED NURSES AND SOME BULLIED PATIENTS. O THER EXHAUSTED NURSES WOULD BE IN TEARS BECAUSE THEY COULD NOT GIVE BASIC CARE Sunday 26.06.11 “The Killing Wards”

19. June 13th 2011

20. E THICAL THEORY Burden Benefit

21. B EAUCHAMP AND CHILDRESS Beneficence Non- maleficence Autonomy Justice

22. T HE F OUR P RINCIPLES Do NOT provide a method for choosing Do provide a common moral language and a common set of moral issues…

23. C ASE STUDY 1 “If my symptoms get worse I’d rather be dead, so I’m going to take an overdose with those pain killers you’ve prescribed me ”

24. Desire for Death Exploration of despair/ vulnerability Intense level of distress conveyed to HCP Time Desire for death changes Protocols blunt instruments Breaking confidentia lity

25. N O EASY ANSWERS