title: Necessity to palliate pain and suffering as a defence to medical homicide.
abstract: The courts, in applying the criminal law in relation to homicide, rely heavily on determining the cause of death, and the existence of intention to cause death. The inadequacy of such processes in relation to prosecutions for medical actions at the end of life is discussed. The principle that there is no "special defence" for doctors is refuted. The legal and ethical obligation of doctors to respect their patients' autonomy, and maximally relieve their pain and suffering, creates a special and exposed position for doctors treating patients near life's end. The result is a quasi-legal practice in which doctors achieve such relief, even though it may commonly hasten death. This medical and legal position has its basis in hypocrisy and obfuscation. The astonishing rarity of prosecution of doctors indicates a "benign conspiracy" on the part of prosecutorial authorities in this regard. It is argued that a transparent and objectively sustainable defence to medical homicide would be a defence based on the necessity to palliate pain and suffering, combined with documented consent by the sufferer to the provision of such palliation.
authors.forename: Rodney
authors.initials: R
authors.lastname: Syme
mesh_terms: D054810:Deep Sedation; D028601:Euthanasia, Active / Q000331:legislation & jurisprudence*; D006801:Humans; D010166:Palliative Care / Q000331:legislation & jurisprudence*; D026684:Personal Autonomy