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OPINION: Who should decide matters of life and death

The death of Vincent Lambert more than a decade after a motorbike accident left him in a persistent vegetative state brought an end to a lengthy legal battle. Samantha David asks: who should make the final decision in the worst of circumstances

In 2008, psychiatric nurse Vincent Lambert sustained a head injury in a motorbike accident. It left him quadriplegic and in a persistent vegetative state. 

In 2013, his doctors said although he could breathe unaided, he could not eat or drink and there was no prospect of him regaining full consciousness. They decided life-saving treatment should be withheld.

His wife Rachel, also a psychiatric nurse, who was his legal guardian after the accident agreed with the medical staff, saying that Vincent had often said he would not wish to be kept alive in such circumstances. Most of his siblings supported the decision, too.

His staunchly Catholic parents and some other relatives disagreed. Battle lines were drawn and court proceedings commenced to make worse an already nightmarish situation.

More than a decade after his accident, after numerous judgements and appeals and new hearings, the courts decided in favour of withdrawing treatment with no possibility of appeal or further legal action. Vincent Lambert died early on Thursday, July 11, 2019.

The pain experienced by both sides of Vincent's thoroughly divided family has been intense. Medical staff must also have found the process stressful, and that's without even counting the financial cost of the legal action and a decade of medical treatment.

Who should decide what happens in such circumstances? Not all of us have made a written request to be kept alive, or not, if we fall in to a vegetative state.
Perhaps we should all do so, although it would be a grim task. But who is to say we wouldn't change our minds?

Doctors have been known to be wrong about their prognoses, and few of them will have known the person they treat before they became unresponsive. So how can they tell?

A spouse might know what the person would have wanted. Or they might not. It's not exactly the usual breakfast conversation. And what parent could possibly face the prospect of medical treatment being withdrawn from a beloved child?

It's an impossible situation. Everyone wants to do the best thing, but where there is no agreement, the courts are being asked to decide what is best. Maybe that is correct; judges can assess the information impartially and make a decision free of emotional entanglements.

This is what happened in the case of Vincent Lambert, but surely the process could have been completed faster? What was gained from dragging the argument out for so many years?

As medicine improves and medical treatments become more sophisticated, the number of people who fall into vegetative states rather than dying, is likely to increase.

So maybe what is needed is an entirely separate legal system which can process these cases faster, reach conclusions more quickly and put everyone out of their misery sooner?

For the record, if it happened to me, I would want to die.

Read more: Support from the Bereavement Support Network

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