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When love brokethe law...

Jim Brady's family stood by him when he developed Huntington's disease - even when it meant breaking the law

Colin Gavaghan

It is the kind of scenario which most people would prefer never even to contemplate, far less have to face. A much loved relative, afflicted by constant suffering and rendered almost entirely helpless by a disease which will eventually kill him, makes repeated pleas for assistance in ending his life. On Boxing Day 1995, Paul Brady made his decision; a decision which came after a prolonged battle with his conscience, but which was to end in a battle for his own liberty.

In 1985, Paul's brother James had learned that he had inherited the gene for Huntington's disease, a degenerative illness of the central nervous system. James knew that this information was effectively a death sentence; the gene for Huntington's is dominant, which means that someone carrying it will always be affected by it, and the disease cannot be cured.

He knew what kind of death he could expect: he, Paul and their sister Margaret had already watched the disease claim the life of their mother some twenty years earlier, and they recalled the mental and physical deterioration which preceded her death. Despite its inevitability, James refused to surrender to his fate. He determined to live as full a life as possible for as long as possible, fighting "like a demon" against the onslaught which the disease waged against his body. He continued to live in his own home and remained active in both his work and his support of his beloved Celtic Football Club.

The progress of the disease, nonetheless, was relentless. Two years after his initial diagnosis he was forced to give up his job as an engineer, and, as his coordination deteriorated further, walking became increasingly difficult and his speech became slurred - a situation rendered all the more humiliating by the fact that his condition was frequently mistaken for drunkeness. In 1993, James was admitted to a nursing home after collapsing in the street.

His decline was so rapid that he was soon bedridden and effectively helpless. It was around that time, according to his sister Margaret, that James began asking her for help in ending his life. Margaret, however, could not bring herself to assist in her brother's death, attempting instead to console James with the vain hope that a cure for his condition might be found.

By Christmas 1995, James was virtually unrecognisable. His wasted muscles were no longer under his control, and his emaciated body was contorted by frequent convulsions. He had developed a variety of complications, including kidney and chest infections and liver damage, and he was barely able to swallow. In addition, he faced the indignity of relying upon his family and carers to attend to his most intimate personal needs. After spending Christmas with his family at Margaret's home, Paul was bathing James when his brother asked once more for help in ending his life.

This time, Paul could deny his brother's request no longer. The following evening, he gave James, who had already consumed a quantity of alcohol, around five or six times his prescribed dosage of Temazepam. When he returned to the bedroom some time later, Paul found James still alive but unconscious, at which point he placed a pillow over his brother's face and suffocated him. He immediately informed the rest of the family what he had done.

Paul was arrested, and remanded in custody. Still reeling from the trauma of James's death, he now faced the horrifying reality of being charged with murder. Legally, he was in a difficult situation. He did not dispute that he had taken his brother's life, nor that he had done so deliberately. Furthermore, his circumstances were not of the sort which would ordinarily see the charge mitigated to one of culpable homicide. This being so, he could well have experienced difficulty in defending himself against the murder charge, and, if convicted, would have faced a mandatory life sentence.

Lord Macfadyen was left greater discretion when it came to sentencing when, in the event, Paul Brady's plea of guilty to culpable homicide was accepted by the Crown. While admitting that he had considered imposing a custodial sentence, Lord Macfadyen eventually elected to admonish Brady. In so doing, he made reference to "a combination of powerful mitigating circumstances" which had influenced his decision, including the fact that Brady had acted out of "compassion rather than from any malicious motive or any desire to make matters easier" for himself. He also referred to the fact that Paul's acts were carried out "at his [James's] own earnest, and plainly heartfelt, request."

The decision elicited the now predictable response from the Roman Catholic Church, with Scottish spokesman Father Tom Connelly stressing that the Church adhered to the maxim that "Thou shalt not kill." Dr George Chalmers, of the Church of Scotland's board of social responsibility, also stated his opposition to euthanasia, expressing concern that the case would establish a precedent. Lord Macfadyen, however, was very careful to emphasize that the illegality of Paul Brady's actions had been recognised, and that it was only the "exceptional" circumstances of this case which had deterred him from imposing a custodial sentence.

Brady's is the second major case concerning end-of-life decisions to be decided before the Scottish courts this year; in April, the Court of Session decided to allow artificial feeding and hydration to be withdrawn from Janet Johnstone. It is, however, the first to deal with an example of what could properly be referred to as voluntary euthanasia.

As with the Johnstone case, the decision in the Brady case has provoked something of a mixed response from advocates of reform in this area. While Lord Macfadyen's decision not to imprison Paul Brady has been widely welcomed, there is also dismay that a case such as this should have to be resolved by recourse to the criminal courts. It is the view of many supporters of a right to die that James Brady's was a classic example of the kind of case in which medical assistance should be available to an individual who wishes to exercise control over the timing and circumstances of his death.

James Brady was incurably and terminally ill, unable to control even the movements of his own body. He was well aware of the fact that the future held only the prospect of more suffering. Yet in order to put an end to his suffering, he had to ask of his own loved ones that they subject themselves to the emotional ordeal of extinguishing his life by their own hands, together with the threat of a lengthy prison sentence.

Further references:

1. "Mercy killing brother admonished" The Herald, 15 October 1996

2. "Man who killed incurable brother freed" The Guardian, 15 October 1996

3. "The courage to kill the one you love" The Observer, 27 October 1996

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