Kerrie Wooltorton, who drank poison and refused life saving treatment, made choices that were challenging for those around her. She decided that she no longer wanted to live her life and took steps to end it. She also decided that, whilst she wanted to be cared for as she died, she did not want life saving or life prolonging intervention, even if this was available.

Neither of these decisions are in themselves unusual, but taken together they do illustrate the demanding aspects of respecting someone’s decisions about the course of their own life. The principle of respecting someone’s choices about their own life is commonly referred to in medical ethics as respect for autonomy, and it is a guiding principle in the way that medicine is practised in the UK today.

It is respect for someone’s autonomy that requires informed consent to be sought before any treatment or interventions can be given, and it is this consent that Kerrie Wooltorton withheld.

Consent to treatment can be given or withheld by any competent adult, and there is nothing to suggest that Kerrie was not competent – she fully understood the implications of her actions, and the clinicians involved took great pains to check this.

What’s important to stress here is that when someone makes a decision to refuse treatment, their reasons don’t have to make sense to anyone else, and they don’t have to be in favour of life over death.

Difficult situations such as this one have arisen before – and will do so again. In 2002, a 40 year old woman known as Ms B went to the High Court to have her ventilator turned off, following a car accident that left her unable to breathe without mechanical assistance. [This case was featured in the British Medical Journal].

The judge in the case, Dame Elizabeth Butler-Sloss, ruled that Ms B’s doctors were wrong to refuse to discontinue treatment (in this case the ventilator) against Ms B’s wishes, even though this would lead to her death.

In an even more challenging case, a contributor to The Open University course Death and Dying talks about how difficult it was to respect the decision of someone she was caring for to refuse medication which might save his life, as he did not want drug companies to profit from his illness. To many people this will seem to be an unreasonable decision, but this does not make it any less valid.

The fact that Kerrie Wooltorton wrote an advance directive, or living will, does not really alter the facts of this case. One of the concerns that is sometimes expressed about advance directives is that they may become out of date, the person involve might change their mind or treatment options might change.

This was not the case for Kerrie – her decision was made at the time of her suicide. In fact, it is likely that she didn’t need her advance directive as she was able to communicate her wishes directly at the time. (An advance directive is intended to convey someone’s wishes about treatment and care should they become unable to communicate these themselves.)

In this respect, this case isn’t about advance directives or living wills at all, it’s about someone making decisions that other people find distressing and difficult to respect.

Find out more

“Unlawfully treated” woman to move to new unit
by C Dyer, C in the British Medical Journal 2002, 324:7340 p753

Discover more about The Open University's Death And Dying course.

Derek Matravers talks to Rebekah Ley, Convenor of the clinical ethics committee for Addenbrookes Hospital

When spending eight months working in one location with one group of people, well give or take a few changes, making sure you achieve the right work-friendship balance is important, not only for your contributors but for yourself as well.

Before moving into a retirement village where every resident is over 55, the majority being in their 70s, I have to say I didn’t think I would make any good friends, where we had any common interests. I have been surprised by the variety of people there and although we talk about different things to my friends and me, electronic drone music not being high up on their agenda, the conversations are still interesting and to be honest it is a privilege to have access to all this history. Obviously we don’t do the same things that I would normally do when socialising, expectations are different and nights not quite so late, but it is an insight into what you can and can’t do in later life.

Over 300 people live in Lovat Fields Retirement Village, so it is inevitable there are going to be some people that I get along with very well. The fact there are 300 people though throws up its own problems. In an enclosed space, such as this retirement village, word spreads very fast and this is something you are particularly aware of very quickly. This means you have to be very wary of what you say at all times, even after a pint or two. If you said anything out of turn about anyone, you can guarantee they will find out about it very soon. As we are filming observational documentaries you are never sure who might be involved in the stories, so you need to make sure everyone is onboard with the programme all the time.

When working and living with people, boundaries need to be set within yourself and it is important that these are rarely crossed. For example, people you know who have a disability might ask you to help lift them into bed and you need to be aware that by trying to help them you may cause them harm and in today’s litigation culture, face a lawsuit. Sometimes, as much as you want to help them, it is safer to call the carers who are trained in these things, no matter the contributor’s grievances about it just being put to bed.

Recently, I have faced a very tough situation with one of our contributors we have been filming for the whole period. Over the last few weeks he has started to deteriorate steadily. He was getting thinner, not eating and generally starting to appear more distant and vague. I would try and encourage him to eat and occasionally make him some food but obviously I still had a job to do so couldn’t sit and ‘nurse’ him all day. It is in these situations where it becomes tough, because you just want to look after them, but you still have your job to do.

The contributor in question has a history of cancer and had an appointment with a consultant. We wanted to film this, so, we filmed around the hospital visit and sat with him and waited while he had his appointment. On coming out he didn’t seem to understand what had been said to him and at this point I realised something was really not right, so upon returning to the village, asked them to look into a care package to keep an eye on him. I kept visiting through the week to check on him and he wasn’t getting any better, so at his next appointment the following week, I went with him again but this time, sat with him in the appointment so someone knew what was being said.

The news was not good at all so I got him home and into bed and relayed the information to the relevant people so further steps could be taken for his care. The other problem was that I was soon to move out of the village, so was genuinely worried about who would be looking out for him in our absence. At times like this it is hard to maintain a professional relationship where you don’t get too involved in interfering with people’s lives, but as a friend and a human being I had a duty of care to this person. Some things are more important than work.

As we have been approaching the end of our time here in Lovat Fields, we have needed to get people used to the fact that we were not going to be around as much as before. Over the last couple of months we have been a less visible presence in the village and this coupled with our repeatedly telling them that we will soon be departing eases the impact of our departure.

Withdrawing from these people’s lives does fill you with a sense of sadness and guilt, but it comes with the territory of the job, so it becomes something that happens once a year. I will still come back to visit a number of people in the village in my spare time, when I get a chance, not only out of duty but because I want to stay in touch with the people I have forged relationships with.

Find out more

Explore grief, loss - and how society deals with death on The Open University course Death and Dying.

Read more about Silverville.

About the author

Bart grew up on the Isle of Sheppey, Kent. After studying film at University he joined BBC Bristol in 2004. Since then he has been a researcher on a number of prime time documentaries. In this series of blogs, Bart is sharing his personal experiences. His views do not necessarily reflect those of The Open University or the BBC.

Subscribe to Bart Corpe's posts

 

I often listen to sport on the radio in the car; my preference is for Test Match Special, when it’s on, but I do listen to football.

I am not alone in this; the average UK motorist apparently listens to football on the radio three times a month. 21% do so  every week and over 6% do so every day, which is two million people all tuning in to football daily as they drive. However, sport, at least not in all its forms, may not necessarily be good for your health. Listening to football commentary on the radio while you are driving could be dangerous and lead to accidents, according to a report commissioned by esure, the car insurance company. 

The research, carried out by the University of Leicester and published in a report called Football Focus, received media attention on 27 May 27, the day of the Champions League Final.

Football is emotional; there’s no doubt about that. Sport elicits powerful commitment and the thought of fans extending the exuberance and distress of the terraces to their driving practices is alarming.

Young man in a car, with raised fist.
[image © copyright Photos.com]

This research suggests that the behaviour of fans is very different from casual listeners, who do not adjust their behaviour behind the wheel in such extreme ways (tail-gating, erratic acceleration and sudden lane changes). I have, for a long time wondered about the embodied responses of spectatorship, for example in being a spectator at the game, especially, in the case of boxing, which I have written about in my book, Boxing, Masculinity and Identity, the i of the tiger (published by Routledge), where being at the fight is a very different experience from the more sanitised spectatorship of pay-for-view television.

However, I have also noted the physical reactions of the sporting follower who is listening at a distance, especially in the case of football with its distinctive style of commentary. I have felt disquiet as the rising crescendo of commentary increases my heart rate and seems to implicate the embodied listener in the waves of emotion evoked in the reporting of the game, even  when I care little for the outcome and my team is not involved at all. 

Sport is sensational, not only in the sense of media hyperbole - it appeals to and implicates all the senses of everyone involved.

The voice of the commentary could itself be a part of the total experience of sport. The research distinguishes between the fan and the uncommitted listener, but I think that there may be something more in the synthesis of the embodied experience that is particular to sport and specific to some sports, especially the genre of football commentary. It is clear that anxiety and exhilaration might lead to other embodied practices, such as accelerating.

This research demonstrates that it is not only sport, on the pitch, and spectatorship, at the ground, that is embodied; so too is the empathy and identification that people have with sport. As I demonstrate in another book, Embodied Sporting Practices (published by Palgrave Macmillan), sport is not only all about bodies, about embodied sporting practices (that is, what sort of physical activities make up what we call sport) it is also about the interaction between everyone involved, including those listening in their cars.  The research also indicates that sport is sensational, not only in the sense of media hyperbole - it appeals to and implicates all the senses of everyone involved.

About the author

Kath Woodward is Profesor of Sociology at the Open University, focusing on gendered identities. She has recently completed research into anti-racist organisations in sport.

Subscribe to Kath Woodward's posts