SIGNIFICANT doubt must now be cast on the decisions to allow people diagnosed as being in a permanent vegetative state to die, a medical practitioner and barrister said yesterday.
Dr Ciaran Craven was speaking after a man seriously injured in the Hillsborough disaster in 1989 begun communicating for the first time in eight years.
"This is bound to reopen the controversy," said Dr Craven, who is an adviser to the Pro Life campaign. "It must surely cast very significant doubt on what was done in other cases. The prudent and ethical approach should always be to err on the side of caution when dealing, with these cases."
Mr Andrew Devine, now aged 30, suffered brain damage during the FA Cup semi final between Liverpool and Nottingham Forest at Sheffield Wednesday's ground in 1989 when he was caught in a crush which killed 95 fans.
He was diagnosed by doctors as being in a permanent vegetative state (PVS) like Tony Bland, another survivor of the disaster, who was allowed to die in 1993 after a ruling by the House of Lords.
In July 1995 the Irish Supreme Court came to a four to one majority decision that a life support feeding system should be withdrawn from a 45 year old brain damaged woman. The woman, who was a ward of court, was in a near permanent vegetative state after suffering serious brain damage during a minor gynaecological operation over 20 years ago.
The woman died in September 1995 after being moved from the hospital where she had spent the previous two decades to her mother's home.
Dr Craven said this case and recent evidence raised questions about the reliability of PVS diagnosis. "I am thrilled to see this man recover. I think what it demonstrates is that sometimes medical science is imperfect."
People in such condition should be looked after just as other patients are, he said.
He added that it is wrong to withdraw ordinary care from someone simply because they are in this state. Feeding a patient is ordinary and not medical care, Dr Craven said.
Dr Bill Tormey, consultant chemical pathologist at Beaumont Hospital in Dublin, called for the establishment of an ethics board which would hear cases put forward by families in right to die cases. It should include medical professionals, legal professionals and members of the public he said.
"People that are diagnosed as PVS should be cared for because the evidence is there that they could come out of it. But families may decide they want to stop treatment. I don't think they should have to go to court but should be heard by such an ethics board," he said.
He said doctors were constantly making difficult decisions about who gets what treatment because of rationing, which is becoming an increasingly important issue.
"We need to separate medicine from economics. There are constant attempts by politicians to get doctors to make decisions based on economics and that is wrong. Much of the attitude about people diagnosed a PVS is economics driven."
He said that a Dail committee should be set up to discuss the health services, debating this issue as well as delays in treatment, unavailability of treatment and transplants.
In the Irish ward of court case the woman's family applied to the High Court to have the life support feeding system withdrawn and the court consented to this. The Attorney General and the institution where she was being cared for appealed the decision.
At the time the Chief Justice, Mr Justice Hamilton, and Mr Justice O'Flaherty, in their judgments, stressed that the case was not about euthanasia. They said euthanasia related to the termination of life by a positive act and that the courts would never sanction that. The case involved the withdrawal of invasive medical treatment. They were only dealing with the rights of the woman.
Botched execution inquiry Governor Lawton Chiles of Florida has ordered an inquiry into the botched execution of a Cuban immigrant which has led to calls for an end to the use of the electric, chair, Joe Carroll writes.
There has been widespread revulsion at reports of how flames shot a foot into the air from the mask covering the face of Pedro Medina as he died in the electric chair in the Florida state prison. As he was strapped into the chair nicknamed "Old Sparky", Medina repeated that he was innocent of the murder in 1982 of Dorothy James, a teacher who had befriended him after he arrived from Cuba.
The victim's daughter and Pope John Paul II had petitioned Governor Chiles to reprieve Medina who was said to have a history of mental illness. Lindi James said that her mother would not have wanted Medina executed.
One horrified witness of the execution, Associated Press reporter, Ron Word, said that "blue and orange flames up to a foot long shot from the right side" of Medina's head, "and flickered for six to 10 seconds ... The smell of burnt flesh filled. the witness room and lingered."
Florida officials say that an alternative method of execution will now have to be considered. Some 38 states now have the death penalty but Florida is one of six that offer no alternative to electrocution.
In 1990 there was another botched execution in Florida when flames and smoke rose from the head of Jesse Tafero while he was being executed for the murder of two police officers. Officials then blamed the fire on a plastic sponge which had been substituted for a natural one used for decades until it wore out.