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THE CHOICE OF "MISS B"

by Diana E Forrest

The court decision allowing Miss B, as she is known, to have a life-sustaining ventilator switched off is not a decision in favour of euthanasia. All the court had to decide was whether Miss B is competent to make decisions about her own medical care. It has been decided that she is; therefore it is now up to Miss B whether she stays on the ventilator. Any idea that the country is full of evil doctors forcing people to stay alive in pain on horrible modern machines and that only the pro euthanasia lobby can rescue them should now be dismissed. Ultimately, the decision is with the patient.

Voluntary euthanasia involves, not stopping treatment, but another person giving treatment that will result in death. Involuntary euthanasia means someone else causing death, either by action or inaction, but without consulting the patient, or even against their wishes. Neither of these applies to Miss B.

However, the B case, though it is not a case about euthanasia, raises issues relevant to the euthanasia debate. It would be arrogant to criticise Miss B, who is clearly no coward. Nor can we know how bad things are for her. All the same, just because one has the right to make a decision, this does not imply that one is making the right decision.

Alison Davis puts the case for life. (Daily Mail, 07.03.2002) She has spina bifida, osteoporosis, and emphysema. She has had the experience of wanting to die. If euthanasia had been legal, she wouldn't be here now. She thinks Miss B's decision is not hers alone. "To say that death might be in her best interests is to say the same thing about me and my severely disabled children." (Ms Davis has helped set up a charity, Enable, for disabled children in India.) She thinks disabled people and non disabled people should be helped equally if they are suicidal. "To accept B's request is in effect to say that severe disability is a fate worse than death."

Another issue is raised by a reported remark from Miss B, quoted on Radio 4, to the effect that she would consider staying alive given more resources. "Quality of life" is often referred to in the euthanasia debate, but it needs pointing out that quality of life often depends upon what income one has. It is worrying that someone should reject treatment, not because nothing is available that would make life bearable, but because they recognise that a bearable life will not be made available to them, due to lack of funds.

Finally, give a thought to Miss B's doctor and care team - there are no villains in this story. They may not have to disconnect her ventilator themselves _ Miss B has agreed to leave the hospital to have this done. But it sounds as if they will still be affected by her death. "Every time I go to her bed, I think: what can I tell her to keep her happy, to give her some enthusiasm and carry on living? I'd had so many chats with her; I enjoy talking to her, but I just find it so hard to find anything to make her happy." (Miss B's consultant, Independent, 07.03.2002)

That's the kind of doctor I want if I'm ever where Miss B is - not some euthanasia enthusiast with their hand hovering over the off switch.