You need to understand that the forensics here, regardless of whether this is England, the US, or any country, is where you run into problems with this type of case. The cases that have developed in hospital murders tend to be where the prosecutor can show a pattern of behavior. In other words, multiple dead bodies. And the probability that the prosecutor is missing a few of them.
First question is going to be why would the authorities do an autopsy on an elderly person dying in a hospital? Hospitals do not do an autopsy on every patient who dies in the hospital. Many of the deaths in a hospital are a predictable result of the patient's condition. Any patient that a doctor is likely to assist in his/her suicide is likely to be terminal regardless of the situation. And in the US at least, would likely have a DNR (do not resucitate) order. And patients are "allowed" to die all the time in hospitals.
But if you get over the hurdle of an autopsy being unlikely, what's the cause of death? Most likely would be an overdose of morphine (i.e., 'snowing'). Assuming the autopsy finds this cause, how do you prove, beyond a reasonable doubt, that it wasn't accidental? Doctor merely says the nurse gave the patient too much morphine, or the morphine pump broke or was disabled, or patient needed that much morphine for the pain level. How is the prosecutor going to prove otherwise?
Normal scenario in the US, and I'm going to guess in the England, goes something like this. Patient goes into the hospital, just about to circle the drain. Doctor tells family that "she'll do everything she can." Doctor realizes that "everything she can" has about as much chance as the snowball in Hell. Family hears that the doctor will save patient.
Patient dies, not surprising the doctor, but shocking the hell out of the family. After all, the patient had been healthy. Doctor says something along the lines of "At least the patient is no longer suffering." Family hears, "I put the poor son-of-a-gun out of his misery." Family quickly translate this into "I offed your mommy (daddy, whoever) because I thought they were suffering too much."
Family bitches to hospital. Hospital investigates, looks at record, see the drain circling, says to the family, "Sorry for your loss, but your mommy was in serious condition. Dr. Murderer did everything they could, but nothing would have saved your mommy." Family translate this to "cover-up."
Family is more ambitious then most and bitches to police/prosecutor. Police/prosecutor investigate, have medical examiner look at file. ME sees the drain circling, tells police/prosecutor and says you don't have a case.
Doctors (and nurses) are incredibly hard to convict of murder in the best of circumstances because they know what drugs are likely to be discovered in an autopsy. There's a very good reason why snowing exists.
Only way you're likely to get a case is if a decision is made (unlikely to be any sort of formal decision and the question becomes quickly whether the decision is medically reasonable) and then someone starts talking.
In the case of both of my parents, decisions were made in their last days that did not maximize their lives. I suppose a case could be made that euthanasia was practiced. But in point of fact, this is normal and depending upon the circumstances, not very unusual.
For a long-term cancer patient, who is stage 4, with "unmanageable pain," the common solution is snowing. You increase the morphine to a point where the patient can tolerate the pain. This is going to probably exceed the level recommended dose, cause the patient to become unconscious, but it doesn't matter in this circumstance, as the patient is terminal. In other words, no matter how much morphine you do or do not give the patient, the patient is going to die. The morphine is going to diminish the patient's ability to fight, speeding the process of death. In other words, the doctor is treating the patient's pain management as the primary objective, rather than the patient's maximum life. Perfectly acceptable medical practice.
I think before you worry about the legal end, you're going to need to do a lot of research on the medical end. You'd need to go back 40 or more years medically to find what you're proposing to be an issue. The cases that are presently out there are all non-terminal patients with the doctor/nurse showing a course of conduct over several patients.
Best of luck,
Jim Clark-Dawe
