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Enforcing Human Rights at End of Life: Is There a Better Approach?

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Book cover Justiciability of Human Rights Law in Domestic Jurisdictions

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Abstract

Questions about the end, and ending, of life are of concern to lawyers, clinicians and society more generally. High profile ‘right-to-die’ and ‘right-to-live’ cases are a frequent focus of media and political attention. In the United Kingdom the recent profusion of challenges that have concerned end of life decision-making has extended from proposals for law reform to adjudication of disputes before domestic and European courts. Tragic and heartrending circumstances typically underscore the complex disputes and challenges that are brought before these courts. The common thread between them is the assertion of human rights violations. On the basis of the outcomes of recent jurisprudence it concludes that attempts to enforce legal rights through the courts should be the last, rather than first, resort since its adversarial approach is not often ideal for the inevitable poignancy of end of life situations. Alternative approaches are proposed as a more positive approach to conflict resolution where possible.

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Notes

  1. 1.

    Hereinafter referred to as “the Convention”.

  2. 2.

    Human Rights Act 1998, section 7(1)(a).

  3. 3.

    Within the meaning of the Human Rights Act 1998, section 7(7).

  4. 4.

    This has been a key characteristic of cases brought following the death of the primary victim (e.g. Nicklinson).

  5. 5.

    Samanta (2012), pp. 382–391.

  6. 6.

    LCB v UK (1998) 27 EHRR 212.

  7. 7.

    Airedale Trust v Bland [1993] 1 All ER 831.

  8. 8.

    R (Application of Mrs Dianne Pretty) v Director of Public Prosecutions and Secretary of State for the Home Department [2002] 1 AC 800.

  9. 9.

    Unless the previously competent person had made a valid and applicable advance decision that pertains to the decision to be taken.

  10. 10.

    Airedale Trust v Bland [1993] AC 789 at 868.

  11. 11.

    Paragraph 5.31.

  12. 12.

    General Medical Council (2010), p. 80.

  13. 13.

    Airedale Trust v Bland [1993] 1 All ER 831.

  14. 14.

    Airedale NHS Trust v Bland [1993] AC 789 at 826 C-E.

  15. 15.

    Bland, p. 862 per Lord Keith.

  16. 16.

    Bland per Lord Browne-Wilkinson, p. 883.

  17. 17.

    Bland, p. 895.

  18. 18.

    Aintree University Hospitals v James [2013] UKSC 67.

  19. 19.

    Bland, p. 861.

  20. 20.

    Bland, p. 897 per Lord Mustill.

  21. 21.

    Bland, pp. 853–854.

  22. 22.

    Wicks (2013), pp. 75–97.

  23. 23.

    Bland, p. 866.

  24. 24.

    Airedale NHS Trust v Bland [1993] AC 789 at 826 C-E.

  25. 25.

    Finnis (1995) (emphasis in the original.)

  26. 26.

    Ohlin (2005), pp. 209–249.

  27. 27.

    NHS Trust A v M; NHS Trust B v H [2001] Fam 348.

  28. 28.

    [2001] Fam 348, p. 30.

  29. 29.

    Airedale Trust v Bland [1993] AC 789 at 805 per Lord Goff.

  30. 30.

    Maclean (2001), p. 785.

  31. 31.

    Aintree University Hospitals v James [2013] UKSC 67.

  32. 32.

    NHS Trust A v M; NHS Trust B v H [2001] Fam 348, p. 29.

  33. 33.

    Royal College of Physicians (2013), p. 79.

  34. 34.

    Practice Direction 9E—applications relating to serious medical treatment.

  35. 35.

    W (by her litigation friend B) v M (by her litigation friend, the Official Solicitor) and Others [2011] EWHC 2443 per Baker J.

  36. 36.

    Royal College of Physicians (2013), p. 63 (although, of course, not all cases are reported).

  37. 37.

    Aston Cantlow and Wilmcote with Billesley Parochial Church Council v Wallbank [2003] UKHL 37.

  38. 38.

    YL (by her litigation friend The Official Solicitor) v Birmingham City Council [2007] UKHL 27 and R (on the application of Heather) v Leonard Cheshire Foundation [2002] EWCA Civ 366 both concluded that private care homes were not public authorities for the purposes of the Convention. This is unfortunate in that these decisions impede the development of a positive culture of human rights.

  39. 39.

    Ahsan v University Hospitals of Leicester NHS Trust [2007] PIQR, p. 19.

  40. 40.

    Ahsan, para 56.

  41. 41.

    Giancino et al. (2002), pp. 349–353.

  42. 42.

    [2011] EWHC 2443: hereinafter referred to as Re M.

  43. 43.

    Mental Capacity Act 20015, section 4(6).

  44. 44.

    [2011] EWHC 2443, p. 57.

  45. 45.

    [2011] EWHC 2443, p. 251.

  46. 46.

    Jackson (2013), pp. 559–561; Kitzinger and Kitzinger (2014).

  47. 47.

    (Representing a limit on interventions that will not be in the clinical best interests of the patient).

  48. 48.

    Aintree University Hospitals v James [2013] UKSC 67.

  49. 49.

    An NHS Trust v DJ and others [2012] EWHC 3524.

  50. 50.

    Ibid., p. 82.

  51. 51.

    Ibid., p. 84(1)(d).

  52. 52.

    An NHS Trust v DJ and others [2012] EWHC 3524, p. 84(4).

  53. 53.

    Sandwell and West Birmingham Hospitals NHS Trust v CD and Others [2014] EWCOP 23.

  54. 54.

    Ibid., p. 35.

  55. 55.

    Ibid., p. 39(1).

  56. 56.

    Ibid., p. 39(3).

  57. 57.

    Re J (A Minor) (Child in Care: Medical Treatment) [1993] Fam 15.

  58. 58.

    R (on the application of Burke) v General Medical Council [2005] EWCA 1003.

  59. 59.

    Human Rights Act 1998, section 6.

  60. 60.

    The guidance has since been revoked and replaced by General Medical Council (2010).

  61. 61.

    Osman v United Kingdom [1998] 29 EHRR 245.

  62. 62.

    Osman ibid., p. 115.

  63. 63.

    Wicks (2013), p. 87.

  64. 64.

    Pretty v United Kingdom [2002] 35 EHRR 1, p. 67.

  65. 65.

    Matthews v Ministry of Defence [2003] UKHL, p. 26 per Lord Hoffmann.

  66. 66.

    R (David Tracey) v Cambridge University Hospitals NHS Foundation Trust and Others [2014] EWCA Civ 33, p. 2.

  67. 67.

    R (David Tracey) v Cambridge University Hospitals NHS Foundation Trust and Others [2014] EWCA Civ 33 per Lord Dyson.

  68. 68.

    Pretty v UK (2002) 35 EHRR 1, pp. 61, 64, 67.

  69. 69.

    Re J (a minor) (wardship: medical treatment) [1991] 1 FLR 366.

  70. 70.

    R (David Tracey) v Cambridge University Hospitals NHS Foundation Trust and Others [2014] EWCA Civ 33.

  71. 71.

    Ibid., p. 32.

  72. 72.

    Olsson v Sweden (No 1) A 130 (1988), p. 62.

  73. 73.

    A useful illustration is provided by R (Purdy) v Director of Public Prosecutions [2009] UKHL 45.

  74. 74.

    Dudgeon v United Kingdom (1981) A 45, pp. 51 and 53.

  75. 75.

    R (Pretty) v DPP [2002] 1 AC 800 per Lord Bingham at 35.

  76. 76.

    R (Nicklinson) v Ministry of Justice [2014] UKSC 38, p. 48.

  77. 77.

    Ibid., p. 96.

  78. 78.

    Airedale Trust v Bland [1993] AC 789 at 885.

  79. 79.

    Pretty v UK [2002] 35 EHRR 1.

  80. 80.

    Haas v Switzerland (2011) 53 EHRR 33, p. 51; Gross v Switzerland (2014) 58 EHRR 7, p. 60.

  81. 81.

    Pretty v United Kingdom (2000) 35 EHRR 1, p. 65.

  82. 82.

    Koch v Germany (2013) 56 EHRR 6, pp. 46 and 51.

  83. 83.

    Haas v Switzerland (2011) 53 EHRR 33, p. 55.

  84. 84.

    R (Purdy) v Director of Public Prosecutions [2009] UKHL 45.

  85. 85.

    Ibid., p. 64.

  86. 86.

    Crown Prosecution Service (2010).

  87. 87.

    R (Purdy) v Director of Public Prosecutions [2009] UKHL 45, p. 55.

  88. 88.

    R (Nicklinson) v Ministry of Justice; R (AM) v Director of Public Prosecutions [2014] UKSC 38.

  89. 89.

    Ibid., p. 76.

  90. 90.

    In accordance with the Human Rights Act 1998, section 4.

  91. 91.

    R (Nicklinson) v Ministry of Justice; R (AM) v Director of Public Prosecutions [2014] UKSC 38, p. 114.

  92. 92.

    Ibid., p. 118.

  93. 93.

    R (Nicklinson) v Ministry of Justice; R (AM) v Director of Public Prosecutions [2014] UKSC 38, p. 137.

  94. 94.

    Lords Neuberger, Mance and Kerr and Baroness Hale.

  95. 95.

    Lords Clarke, Sumption, Reed and Hughes.

  96. 96.

    For example in Re A (Children) (conjoined twins) [2000] 4 All ER 961 at 969 per Ward LJ.

  97. 97.

    Airedale Trust v Bland [1993] AC 789, p. 878.

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Case Law (Strasbourg)

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Authors and Affiliations

  1. De Montfort University, Leicester, UK

    Jo Samanta

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  1. Jo Samanta
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Correspondence to Jo Samanta .

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Editors and Affiliations

  1. Department of Law and Criminology, Edge Hill University, Ormskirk, Lancashire, United Kingdom

    Alice Diver

  2. School of Law, Northumbria University, Newcastle, United Kingdom

    Jacinta Miller

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Samanta, J. (2016). Enforcing Human Rights at End of Life: Is There a Better Approach?. In: Diver, A., Miller, J. (eds) Justiciability of Human Rights Law in Domestic Jurisdictions. Springer, Cham. https://doi.org/10.1007/978-3-319-24016-9_1

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