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Observations Legal Tender

Live and let die

BMJ 2009; 339 doi: (Published 07 October 2009) Cite this as: BMJ 2009;339:b4112
  1. Sheila A M McLean, director of the Institute of Law and Ethics in Medicine, University of Glasgow
  1. s.mclean{at}

    The case of Kerrie Wooltorton rests solely on whether or not her decision to refuse lifesaving treatment was legally competent

    The inquest into the death in 2007 of Kerrie Wooltorton (BMJ 2009;339:b4070, doi:10.1136/bmj.b4070) has focused media attention on advance decisions (directives) or “living wills.” It has provoked some commentators to argue that giving legal standing to competently executed advance directives, as the Mental Capacity Act 2005 does, is a step too far onto a potentially slippery slope. (It is worth noting that this act does not apply to Scotland.) Although it is undoubtedly a tragic case, it is worthwhile to unpick what we can learn from it and what the main issues at stake are.

    Ms Wooltorton had apparently ingested antifreeze on up to nine previous occasions but had nonetheless accepted lifesaving treatment after these incidents. To complicate matters, she was also said to have had an “untreatable” emotionally unstable personality disorder. The final twist in this complex story was that a few days before her death she had drafted an advance statement indicating that she did not wish to be treated should the same circumstances arise in the future, even if she called an ambulance. Rather …

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