A Moors Murderer, Resuscitation and Medical Certainty

Brady and his crimes, of course, stir up strong emotions and continuing interest from law enforcement. Only in August, Ms Powell was arrested after telling the makers of a television documentary that Brady had sent her a letter to be given after his death to Winifred Johnson, the mother of Keith Bennett, the only one of his victims whose body has still not been found.

The fascination with the Moors Murders has fuelled more headlines in the last few weeks.

Ian Brady, who, together with his former partner Myra Hindley, murdered five children in the early 1960s, was back on the front pages.

His mental health advocate told reporters that his heart had temporarily stopped beating after he suffered a fit in July.

Jackie Powell's revelations were not just of interest because of Brady's notoriety or that his collapse came as he was preparing for a tribunal which might see him granted a wish to be returned from a secure mental unit to the general prison population.

She suggested that, in addition to making her executor of his will, Brady had informed the authorities at Ashworth Hospital on Merseyside that he did not wish to be resuscitated if he ever lost consciousness.

Ms Powell claimed that paramedics had used a defibrillator to bring Brady back to life.

Brady and his crimes, of course, stir up strong emotions and continuing interest from law enforcement. Only in August, Ms Powell was arrested after telling the makers of a television documentary that Brady had sent her a letter to be given after his death to Winifred Johnson, the mother of Keith Bennett, the only one of his victims whose body has still not been found.

Mrs Johnson never lived to receive the note. Sadly, she died of cancer as speculation swirled in the media as to whether the letter contained the whereabouts of Keith's remains.

The most recent reports, though, raised the issue of how individuals who make clear their intention to refuse treatment - whatever their circumstances - can ensure those wishes adhered to.

There are two documents designed to record such thoughts. The first is known as a Lasting Power of Attorney, or LPA for short. Put simply, it transfers the authority to make decisions on someone's behalf about accepting or refusing life-sustaining treatment.

The second is an 'Advance Decision', also commonly referred to as a 'living will' and allows individuals to give notice of their intention to refuse treatment in specific future circumstances should they have lost the capacity to decide in the meantime.

As I write, it's still not clear if Ian Brady had made either document or had simply set down his wishes in a self-written letter to Ashworth's managers. His refusal of normal treatment had been well-documented since his beginning a hunger strike in 1999.

Nor is it certain whether the doctors treating Brady over-ruled his intentions because they had not been set down in the correct manner or because he was not judged to have the degree of mental capacity required for the documents to be followed.

Recently, I have written here and elsewhere about evidence from my own workload suggesting that LPAs are becoming more popular.

The Office of the Public Guardian has recently spoken of its ambition to ensure that everyone in the UK has an LPA. Already, the documents are growing in popularity with the number of LPAs registered in the last year showing a notable increase on the previous 12 months.

However, there is no central register of 'living wills', something which could lead to problems for doctors required to provide care for incapacitated individuals and the people they treat.

The advent of Summary Care Records - electronic dossiers containing patients' essential data - offers one way to address that issue. However, recent media reports suggest that system is not operating perfectly.

For the time being, it seems that the only way to avoid any difficulties and make sure that your wishes are followed is by preparing a Lasting Power of Attorney now and, crucially, alerting your family and those individuals whom you appoint as Attorneys to its existence.

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