The husband of a woman in a persistent vegetative state (PVS) who was given a sleeping pill that was said to have “woken up” some patients has called for an urgent inquiry into the use of the drug on his wife.
The president of the High Court's family division, Sir Mark Potter, sanctioned a brief trial of zolpidem on the woman, named only as J, before a final decision was taken to withdraw artificial nutrition and hydration and let her die.
Sir Mark agreed to the treatment at the request of the then official solicitor, Laurence Oates, who was acting for J, and wanted to give her a chance of responding to the drug even though her family opposed the attempt.
The expert witness for the official solicitor, Keith Andrews of the Royal Hospital for Neuro-disability in Putney, southwest London, doubted the drug would work but told the judge it gave a “glimmer of hope, a possible upside, with no real downside in terms of patient welfare.”
However, J's family feared she might awake temporarily and become aware of her profound disability. They wanted her to die with dignity. Her mother, a retired psychiatrist, told the judge in a statement that it seemed “unbearably cruel” to keep her alive.
“What happened to [J] was alien and inhumane,” her husband, aged 55 years, who may not be named because of a court order, told the Daily Telegraph newspaper (19 January 2006, p 1).
“Somewhere along the line people have forgotten that just because you can perform a particular medical treatment doesn't necessarily mean that you should. In Jessica's case she was given a drug that she wouldn't have wanted. Zolpidem is not even an established treatment for PVS patients. I find it staggering that she was given it.”
He added, “It seems to me vitally important that an organisation such as the BMA should consider the issues involved.” J's mother, brothers, and two daughters were against what they regarded as little more than an experiment.
The drug, which was tried three times, acted only as a sleeping pill, pushing her deeper into sleep, and she was allowed to die last month.
The new official solicitor, Alastair Pitblado, refused this week to rule out using zolpidem on future patients in persistent vegetative states. “It would all depend on the expert advice,” he told the BMJ. “I couldn't prejudge what a particular expert would say.”
Vivienne Nathanson, head of science and ethics at the BMA, said, “We've now had enough cases of PVS going to court that we have a body of medical opinion, and the question is whether we really need to keep going to court on every single case, because that is certainly one of the major factors that distress families. Instead we could all work to guidelines that are agreed on the basis of the cases which have gone to court so far.”