権利-to-die 事例／患者: 嘆願 for doctors

The woman who wants her life-support machine switched off today heard an 情熱的な 嘆願 about the 影響 it would have on doctors if she 勝利，勝つs her 法廷，裁判所 戦う／戦い.

A ビデオ link connects her hospital 区 to the High 法廷，裁判所 and she could be seen listening intently as Robert Francis QC explained how her 医療の team would 見解（をとる） a 法廷，裁判所 判決，裁定 that she had the capacity to decide that doctors must switch off the ventilator keeping her alive.

He said: "These doctors are working at the very frontier of life with people at 危険 of death and they are struggling to keep them alive."

He told Dame Elizabeth Butler-Sloss, the 大統領 of the Family 分割 who must make the 決定／判定勝ち（する）, that if she gave the 患者 the 権利 to choose her 運命／宿命: "Suddenly, doctors will be 要求するd by 法律 with a competent 患者 to stand 支援する and 逆転する what they have been doing."

Three large ビデオ 審査するs showing the 43-year-old woman in her bed 支配する the courtroom.

Mr Francis said: "I can put it in 公正に／かなり graphic 条件. If you look at the room where 行方不明になる B (her 身元 is 保護するd by 法廷，裁判所 order) is 存在 扱う／治療するd, and if ventilation were to be 終結させるd, just 負かす／撃墜する the 回廊（地帯） there are other 患者s which the doctors are struggling to keep alive."

He said that in most 事例／患者s it was doctors who have to make the 決定／判定勝ち（する） on whether to 身を引く 治療 in 事例／患者s where その上の care would be useless.

"This very 激しい 重荷（を負わせる） society places on the 医療の profession because there is no other place to put that 重荷（を負わせる）.

"It cannot be in the public 利益／興味 or 患者 that in 新規加入 to the 窮地 that doctors 直面する over 治療 they would have the 付加 重荷（を負わせる） of a 判決，裁定 that what they are doing is unlawful."

Mr Francis had begun this morning by 賞賛するing the "courage and dignity" of 行方不明になる B who has been in an 集中的な care 部隊 at a hospital in the London area for more than a year since a 決裂d 血 大型船 in her neck left her paralysed from the neck 負かす／撃墜する and unable to breath unaided.

He said she had 対処するd "with the most appalling adversity".

"I have nothing but 賞賛 for her and it has been a 特権 to have known her."

He 追加するd: "There is also the dedication and 技術 of the 医療の team in their care of 行方不明になる B.

"There is 衝突 between their 倫理的な 義務s to do their best to save a 患者's life and かかわり合い to their 患者's health and a 患者's wish that life-saving 治療 should be stopped."

Dame Elizabeth said she did not have to make a 決定／判定勝ち（する） on whether the 患者 lived or died but whether she has the capacity to make the 決定／判定勝ち（する） on her 医療の 治療.

Dame Elizabeth said that if the woman did choose not to 受託する 治療, she had only a 1% chance of 生き残るing without ventilation and that would 必然的に lead to her death.

Mr Francis replied that as the 法律 now stood the capacity to make the 決定／判定勝ち（する） was 相応した with the gravity of the choice.

Mr Francis said it was possible, if not probable, that 行方不明になる B's capacity was 影響する／感情d by the gravity of her 条件, the 環境 in which she was 存在 扱う／治療するd and her 関係 with her doctors and carers.

"This lady is 苦しむing from the most 厳しい form of physical disability imaginable and it is possible that this 圧倒するs her ability to believe that rehabilitation would make a difference," he said.

It was analogous to extreme 苦痛 or phobia which could （判決などを）下す 決定／判定勝ち（する）-making difficult or impossible.

"She has been in this 部隊 for a year の中で 患者s who are 本気で ill, many terminally ill, and doctors who are struggling to keep people alive. It must be 近づく impossible to believe that life could be different, ーに関して／ーの点でs of 質, どこかよそで."

At one point, she had said that, had she been 申し込む／申し出d a rehabilitation place earlier on, her 態度 might have been different.

Mr Francis 示唆するd her 関係 with and 態度 に向かって doctors and other care rs and her 怒り／怒る and 激しい feelings at the way she was 存在 扱う／治療するd could （判決などを）下す her unable to balance 事柄s in her mind.

Dame Elizabeth said she 設立する that argument unattractive.

The 裁判官 went on: "She is getting very annoyed because they won't listen to her. To 示唆する that her 怒り／怒る and its 影響する／感情 on her 関係s should be 扱う／治療するd as a loss of capacity is to underestimate the feelings of 患者s in hospitals.

"She is angry with them for 扱う／治療するing her in a 温情主義的な way as though she isn't fit to make a 決定／判定勝ち（する）. If you are lying there and not 存在 listened to, I'm not sure this goes to 欠如（する） of capacity. A lot of 患者s would 絶対 反対する to that.

"Serious 失望／欲求不満 and 怒り／怒る are natural emotions. You have to go a long way to say that distorts capacity."

Mr Francis said 行方不明になる B's 怒り／怒る and 失望／欲求不満 did not point to 欠如（する） of capacity in themselves.

The question was whether they could create circumstances in which she was unable to make a proper 決定／判定勝ち（する）, however coherent, 強烈な and 明らかに competent she was.

Because of the gravity of the 決定／判定勝ち（する） she had made, the doctors, who 同意しないd with her, were understandably 関心d to 設立する she was competent to make it.

The 裁判官: "You seem to be 説 that if you want something and the doctors don't think it is a good idea because they want to do something else, the more you 同意しない the more you will be regarded as unable to make a 決定／判定勝ち（する）.

"That is a dangerous 概念. There is a very 温情主義的な element. It's a very 'doctor knows best' 概念. I really bridle at that as a member of the public 同様に as a 裁判官."

Mr Francis said the health 信用 did not 是認する any 温情主義的な 態度. It 尊敬（する）・点d the 自治 of 患者s - so long as it was 設立するd they were competent to have that 自治. The 信用 had a public 義務 to 確実にする that the 権利 thing was done.

He pointed out that 行方不明になる B had on occasions been ambivalent about what she 手配中の，お尋ね者 to happen .

There had been 出来事/事件s when her life-支えるing ventilation could have been withheld and on each occasion she either 表明するd 救済 that it was not or 受託するd 延長／続編 of her 治療.

This raised a question as to whether she was as 明白な in her mind as she said she was - whether, when she said no, she really meant it.

As to the suggestion that doctors were breaking the 法律 by continuing to 扱う／治療する her, Mr Francis said it could not be unlawful to continue 治療 while there were 合法的 疑問s about her capacity to make a 決定／判定勝ち（する）.

Philip Havers QC, 代表するing the 患者, said she had 拒絶するd all forms of 治療 and rehabilitation, and an 試みる／企てる to 離乳する her off the ventilator.

But since last August, when two psychiatrists 宣言するd she had the capacity to make the 決定／判定勝ち（する） on whether to 辞退する 治療, no-one had listened to her wishes.

Dame Elizabeth said she was 気が進まない to accede to his request to 支配する that the hospital had been 事実上の／代理 unlawfully.

"She has been in an 集中的な care 部隊 where it is the doctors' 職業 to keep her alive. I don't want to give doctors the impression that they have to be 用心深い when they 扱う／治療する people."

He said that if there was a finding of unlawfulness, he would be 捜し出すing 名目上の 損害賠償金 of no more than £200.

Peter Jackson QC, 代表するing the 公式の／役人 Solicitor who 介入するs in 権利-to-die 事例／患者s, said: "Any 決定／判定勝ち（する） in this 事例／患者 would have no 消極的な 関わりあい／含蓄s whatever for other people under a disability. Each would be the 単独の 裁判官 of their own lives."

He said that 行方不明になる B was not someone who placed a low value on life.

"On the contrary she places a high value on life. Her 質 of life and enjoyment of life beforehand makes it so difficult for her now."

Reserving her judgment, Dame Elizabeth said: "This is a 特に difficult 事例／患者."

She 追加するd: "There has been no suggestion that the doctors 扱う／治療するing 行方不明になる B have not done so to the highest 基準s and wit h the most 充てるd care and 行方不明になる B herself has 受託するd that their physical care of her was of the highest 基準s."