Doctor admits using drugs to end babies' lives

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The Independent Online
A doctor admitted yesterday that he had ended the lives of two severely handicapped newborn babies by increasing their dose of pain killers.

Dr Richard Nicholson, now editor of the Bulletin of Medical Ethics, said the incidents happened 20 years ago.

Speaking at a briefing before a television current affairs programme in which he tells of the dilemma, Dr Nicholson said: "I have no way of knowing whether the drugs killed those babies or whether they died of the diseases we were expecting them to die of."

But, Dr Nicholson said: "I think it's very difficult to know exactly what my intention was. Certainly it wasn't just to relieve pain. It was to relieve the distress of nursing staff and of the parents and certainly part of the intention was to bring about the death of the babies.

"Even now I still think that was the most humane thing to do, though I thought then and still think now technically what I was doing was against the law. I don't think that I would behave in that way again now, because hospitals have become so much more public places and one would inevitably have [anti-abortion organisations like] Life or Spuc on to the police straight away," Dr Nicholson said.

Both the babies had spina bifida and hydrocephalus and needed pain relief for the second condition. They were expected to die and consultants had agreed with the parents that they should be allowed to die. They lingered. Over one week-end, Dr Nicholson increased the pain relief dose.

Professor Garth McClure, president of the British Association of Perinatal Medicine, said of Dr Nicholson's statements: "Such cases today are very rare but sometimes it would be true that you need to give such analgesic to stop pain that life ends. If this is a consequence, so be it. But there is no express purpose to terminate a life."

The programme, to be broadcast tomorrow in the 3D series on ITV, reopens the debate over the rights of severely handicapped babies and their parents, and the dilemma facing doctors over the provision of life-support to very premature babies.

In 1990, the case of "Baby J" established a legal basis for making decisions when a court was brought in to decide on the fate of the baby, severely brain-damaged at birth. The baby had an uncertain life expect- ancy but was not terminally ill. The court ruled that treatment could be withheld in this particular case.

Dr Fleur Fisher, head of the ethics division of the British Medical Association, said: "Things have moved forward enormously since the 1970s. This ruling is crucial in this debate. The court said that if life would be so intolerable that a person would choose to die should they be able to decide, then a decision not to give treatment could be taken.

"Its effect was to recognise a limit on a doctor's duty to treat."

But this was not the same as deliberately ending a life, which was not permissible. "We are not aware of this happening," she said.

She said fewer handicapped babies were now born because of prenatal screening and termination but there was increasing ability to keep alive very premature babies who could not survive without support.

"A complication of prematurity is brain haemorrhage. Then the decision has to be made whether to continue massive intensive care or not.

"The decision is made carefully with the parents and other specialists who would have to be responsible for the child's future," she said.

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