High Court rejects Tony Nicklinson's plea to allow doctors to end his life

When does the right to life become a right to die?

Today the High Court rejected Tony Nicklinson's plea to allow doctors to end his life. Nicklinson is not terminally ill, but for the past seven years he has been "locked in" as a result of a stroke: fully conscious, but immobile, able to communicate only by blinking. With the full support of his family, he had asked the court to extend the defence of necessity to cover doctors who acceded to his request. As the law stands, any doctor who carried out his earnest request might have found themselves facing a charge of murder. He also hoped to establish that his human right to a private life (under Article 8 of the European Convention) included the right to choose the manner of his death.

The result isn't a surprise. Nor will it be the end of the matter: the family had already announced their intention to appeal should the decision go against them. In the end, though, even the highest court in the land might well conclude, as this hearing did, that such a profound change in the law could only be made by act of Parliament. "It is not for the court to decide," said Lord Justice Toulson this afternoon, "whether the law about assisted dying should be changed and, if so, what safeguards should be put in place." Yet there seems little immediate prospect of legislation. Despite decades of debate and the fact that public opinion has long been sympathetic to euthanasia (provided that there are strict safeguards to protect the vulnerable) Parliament has so far proved reluctant to act.

Instead, the law finds itself in a position of moral incoherence. On the one hand, it refuses to draw distinctions that most normal people would regard as obvious. As the Lord Chief Justice made clear in 2010, upholding the murder conviction of a mother who ended the life of her severely brain-damaged son, the law "does not distinguish between murder committed for malevolent reasons and murder motivated by familial love." A law that puts a loving mother in the same legal category as Ian Huntley, sentencing both to life imprisonment (albeit with different tariffs), is clearly deficient. Nor can the Crown Prosecution Service be relied upon to act with common sense and compassion in such cases. 

At the same time, the law draws distinctions that are, in moral terms, pedantic. For example, it makes what is taken to be a significant distinction between actively ending someone's life (for example, by administering a lethal cocktail of drugs) and passively doing so by withdrawing nutrition. The latter has, since the Tony Bland case twenty years ago, become an almost standard procedure in cases where a patient is assessed to be in a persistent vegetative state with no hope of recovery. The difference means almost nothing to the person concerned - who is unable to express a preference either way. Tony Nicklinson himself could choose to refuse nutrition. This would condemn him to a slow and agonising death, and increase the suffering of his wife and daughters who would be forced to look on helplessly. But it would be legally OK. Death by lethal drugs would be quicker, painless and dignified. But it would be murder. 

If Tony Nicklinson were a dog, it would not merely be legal to end his suffering, it would be a criminal offence not to do so. The RSPCA routinely prosecutes pet-owners who cannot bear to see their beloved animals put down. Perhaps the dog, if it could talk, would express a wish for its suffering to end; perhaps it would cling to life. Society assumes, though, that to be merciful and compassionate is to put the animal to sleep. Why should a fully conscious and intelligent adult human being be treated with less humanity and compassion than a dog? 

The usual answer is that the law exists to protect vulnerable people who might otherwise feel under pressure to choose death so as not to be a "burden" on their loved ones. But their must be other, less cruel, ways of protecting the vulnerable. And the current law risks imposing another sort of burden on the families of people in Tony Nicklinson's position: a stark choice of watching someone you love in agony and asking to die, or acceding to their request at the risk of being convicted of assisted suicide or even murder. 

It's also sometimes argued that to allow profoundly disabled people the right to euthanasia would undermine the value of the lives of all people with similar disabilities. This must be nonsense. To respect human life is to respect more than the continuance of bodily functions: it is to afford respect and dignity to individuals, and that means allowing people to make decisions about their own lives. Including the ultimate decision to end it. 

A civilised and compassionate society will allow, even encourage, people to make the most of life whatever physical or mental disabilities they may have. We will shortly see at the Paralympics a triumphant demonstration of the fact that disability is no bar to achievement. It's possible to have even Tony Nicklinson's level of disability and lead a positive and worthwhile, even successful, life: just look at Stephen Hawking. But forcing someone to live against their will, as a demonstration of society's attachment to the sanctity of life, is neither civilised nor compassionate.

There is, in fact, no real conflict between the sanctity of life and the right of someone in Tony Nicklinson's position to end it. If human life has any special meaning over and above any other sort of life, it is because human beings are capable of self-reflection, of mental anguish, of conscious suffering, which includes the knowledge that one's suffering will end only in death. In such a case as Tony Nicklinson's, such human characteristics only add to the predicament in which he finds himself. For him, the right to die has become indistinguishable from the right to life.

What such a situation reflects, perhaps, is a continuing desire on the part of the law (or of its defenders) to want to punish suicide. A nominally secular society continues to see suicide not as a viable option - even an affirmation of life, because it is an affirmation of autonomy - but as a moral and personal failure, an admission of defeat. This was the mentality that for centuries refused suicides burial in consecrated ground. It is an attitude that ultimately limits human dignity, while at the same time pretending to exult it.

 

Tony Nicklinson's wife Jane comforts him as he reacts to the High Court decision. Photograph: Getty Images
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Inside Big Ben: why the world’s most famous clock will soon lose its bong

Every now and then, even the most famous of clocks need a bit of care.

London is soon going to lose one of its most familiar sounds when the world-famous Big Ben falls silent for repairs. The “bonging” chimes that have marked the passing of time for Londoners since 1859 will fall silent for months beginning in 2017 as part of a three-year £29m conservation project.

Of course, “Big Ben” is the nickname of the Great Bell and the bell itself is not in bad shape – even though it does have a huge crack in it.

The bell weighs nearly 14 tonnes and it cracked in 1859 when it was first bonged with a hammer that was way too heavy.

The crack was never repaired. Instead the bell was rotated one eighth of a turn and a lighter (200kg) hammer was installed. The cracked bell has a characteristic sound which we have all grown to love.

Big Ben strikes. UK Parliament.

Instead, it is the Elizabeth Tower (1859) and the clock mechanism (1854), designed by Denison and Airy, that need attention.

Any building or machine needs regular maintenance – we paint our doors and windows when they need it and we repair or replace our cars quite routinely. It is convenient to choose a day when we’re out of the house to paint the doors, or when we don’t need the car to repair the brakes. But a clock just doesn’t stop – especially not a clock as iconic as the Great Clock at the Palace of Westminster.

Repairs to the tower are long overdue. There is corrosion damage to the cast iron roof and to the belfry structure which keeps the bells in place. There is water damage to the masonry and condensation problems will be addressed, too. There are plumbing and electrical works to be done for a lift to be installed in one of the ventilation shafts, toilet facilities and the fitting of low-energy lighting.

Marvel of engineering

The clock mechanism itself is remarkable. In its 162-year history it has only had one major breakdown. In 1976 the speed regulator for the chimes broke and the mechanism sped up to destruction. The resulting damage took months to repair.

The weights that drive the clock are, like the bells and hammers, unimaginably huge. The “drive train” that keeps the pendulum swinging and that turns the hands is driven by a weight of about 100kg. Two other weights that ring the bells are each over a tonne. If any of these weights falls out of control (as in the 1976 incident), they could do a lot of damage.

The pendulum suspension spring is especially critical because it holds up the huge pendulum bob which weighs 321kg. The swinging pendulum releases the “escapement” every two seconds which then turns the hands on the clock’s four faces. If you look very closely, you will see that the minute hand doesn’t move smoothly but it sits still most of the time, only moving on each tick by 1.5cm.

The pendulum swings back and forth 21,600 times a day. That’s nearly 8m times a year, bending the pendulum spring. Like any metal, it has the potential to suffer from fatigue. The pendulum needs to be lifted out of the clock so that the spring can be closely inspected.

The clock derives its remarkable accuracy in part from the temperature compensation which is built into the construction of the pendulum. This was yet another of John Harrison’s genius ideas (you probably know him from longitude fame). He came up with the solution of using metals of differing temperature expansion coefficient so that the pendulum doesn’t change in length as the temperature changes with the seasons.

In the Westminster clock, the pendulum shaft is made of concentric tubes of steel and zinc. A similar construction is described for the clock in Trinity College Cambridge and near perfect temperature compensation can be achieved. But zinc is a ductile metal and the tube deforms with time under the heavy load of the 321kg pendulum bob. This “creeping” will cause the temperature compensation to jam up and become less effective.

So stopping the clock will also be a good opportunity to dismantle the pendulum completely and to check that the zinc tube is sliding freely. This in itself is a few days' work.

What makes it tick

But the truly clever bit of this clock is the escapement. All clocks have one - it’s what makes the clock tick, quite literally. Denison developed his new gravity escapement especially for the Westminster clock. It decouples the driving force of the falling weight from the periodic force that maintains the motion of the pendulum. To this day, the best tower clocks in England use the gravity escapement leading to remarkable accuracy – better even than that of your quartz crystal wrist watch.

In Denison’s gravity escapement, the “tick” is the impact of the “legs” of the escapement colliding with hardened steel seats. Each collision causes microscopic damage which, accumulated over millions of collisions per year, causes wear and tear affecting the accuracy of the clock. It is impossible to inspect the escapement without stopping the clock. Part of the maintenance proposed during this stoppage is a thorough overhaul of the escapement and the other workings of the clock.

The Westminster clock is a remarkable icon for London and for England. For more than 150 years it has reminded us of each hour, tirelessly. That’s what I love about clocks – they seem to carry on without a fuss. But every now and then even the most famous of clocks need a bit of care. After this period of pampering, “Big Ben” ought to be set for another 100 or so years of trouble-free running.

The Conversation

Hugh Hunt is a Reader in Engineering Dynamics and Vibration at the University of Cambridge.

This article was originally published on The Conversation. Read the original article.