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The Lord Chancellor has warned UK doctors that if they violate advance directives refusing treatment, they could go to jail. Now, I certainly believe it is important to respect a patient’s desires in this regard; but jail? There are an awful lot of areas of ambiguity in these matters and the threat of jail certainly pushes decision making toward a decision for death.

Moreover, the sacrosanct nature of advance directives isn’t a two way street. In the UK, if a patient wants to continue to receive life support, has stated so in an advance directive, and is either unconscious or unable to communicate further, no jail threats against doctors for “pulling the plug.” Indeed, the Leslie Burke case gave doctors that very power. (We see the same paradigm at work here in the USA with the encroachment of Futile Care Theory on patient autonomy.)

So, in the UK, violate an advance directive causing a patient to live, and face jail. Violate an advance directive leading to a patient’s death, and it is merely medical ethics.


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