Posted by: Witch Doctor | October 15, 2009

Beyond reasonable doubt


Andy Cowper made a comment on one of  Dr Grumble’s recent posts.

He introduced a term usually heard in legal context.

“Beyond reasonable doubt.”

This concept seems to The Witch Doctor to be important in the allowed suicide of Kerry Wooltorton.

The Witch Doctor wonders how many doctors, if faced with the decision to allow this young woman’s life to end, could say to themselves that it was “beyond reasonable doubt” that suicide was really intended at the time the decision not to treat was made.

Furthermore, even if it seemed it was “beyond reasonable doubt” then, how many doctors could say “it was beyond reasonable doubt” that she would be sure she wanted to die a week onward, a month onward, a year onward, five years onward, a lifetime onward.

None, probably.


So, are patients to be allowed to die nowadays when the criteria of “beyond reasonable doubt” is not satisfied?

Is that what medical students are now going to be taught?

Is this how the next generation of doctors will be expected to behave?

Can this term ever be satisfied longitudinally in the context of suicide?

I think not.

This week, it was reported that a widow received a settlement following the death of her husband in a hospice.


It was because the controversial Liverpool Care Pathway was initiated.

However, it is reported that the patient was “cured” of his “terminal” cancer and was in fact was suffering from a treatable pneumonia.

Presumably though, the consultant concerned who decided on the terminal “treatment” felt it was “beyond reasonable doubt” that the patient would die soon from recurrent cancer.

This brings to mind a lesson that The Witch Doctor remembers way back as a medical student.

“Never diagnose cancer without histology.”

Maybe  The God Doctors among us don’t need histology.

The Witch Doctors, however, are not so clever.

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  1. D’ know the problem with all of this? You’ve got to have the whole damn discussion of ‘best interests’ , ‘reasonable doubt’ ‘valid advance directive’, ‘not contrary to suicide act’ yada yada yada, while someone is lying dying. A law’s not working if you have to go to the Court of Protection every time you have to make a decision. They need to repeal it.

  2. You are absolutely right, Julie.

    A blogger elsewhere mentioned “Wicked Problem.” I had never come across this term before but I think he is right.

    Discussion and argument goes round in circles with a “Wicked Problem” and may make matters worse.

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