On the manslaughter question it's a difficult one. On a strict intepretation of the law the prosecution would have to show that Tom's failure to treat the patient was negligent and that the negligence was gross. By attending the patient Tom has undertaken to care for them and thus owes them a duty of care. Tom then has to discharge that duty of care by meeting the standard of care of the reasonably competent paramedic (more on how we decide this later). Let us say that Tom's initial treatment was textbook. In theory the matter should end there as Tom would have discharged his duty of care. But what if Tom had decided to ignore his instincts, left the patient and the patient died? That's a slightly greyer area. The question would arise what the extent of Tom's duty of care was - i.e. was he under a duty to ensure the patient recovered fully (I can't answer that) - and whether, by leaving the patient, Tom had acted in accordance with a practice accepted as proper by a responsible body of paramedics. Given the feedback I've seen on this blog so far, I think that may prove problematic. The finer points of the law can be argued to the nth degree, but this gives you something to start thinking about. On the suicide issue the law is clear. If a patient dies as a result of a healthcare professional accepting their refusal of treatment, this does not amount to assisted suicide.