Medicine

UK court ruling seen as landmark in right-to-die cases

UK court ruling seen as landmark in right-to-die cases

"A person in a persistent vegetative state exists in an altered state of consciousness following some kind of trauma".

It also highlighted an earlier judgment's decision that clinically assisted nutrition and hydration (CANH) is "to be seen as medical treatment".

Today, the decision was upheld.

Supreme Court Justice Lady Black said agreement between families and doctors provided sufficient safeguards for public confidence in the process, BBC News reports.

However, she urged families to apply to court where there are differences of view between medical professionals and relatives.

The Supreme Court made the ruling as it quashed an appeal regarding a case in which relatives of a man left in a permanent coma by an extensive brain injury chose to withdraw the treatment keeping him alive. He was believed to have no chance of recovery.

He had not left a living will or any instructions on what should happen to him in the case of sudden illness, so his family and doctors agreed to allow him to die by withdrawing his feeding tube, but an application had to be made to the Court of Protection first. The High Court judge sided with the trust.

The Official Solicitor appealed this decisionto the Supreme Court in a hearing in February.

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The Supreme Court determined that the Bland case did not impose a legal requirement that in all cases of patients in PVS an application must be made to the Court before CANH can be withdrawn. The House of Lords, hearing the case in 1993, declared that it was lawful to withdraw that treatment having regard to the clinical evidence that it was of no therapeutic benefit to him and therefore it was not in his best interests for that treatment to continue.

"There is a clear difference between turning off a ventilator on a brain-dead patient and removing (nutrition and hyrdration) from a brain-damaged patient", he said.

Previously, independent experts in the Court of Protection would have considered Mr Y's case. "Given the huge and growing financial pressure the health service is under is this really an additional pressure, no matter how subtle we want to put medical staff and administrators under".

"Coupled with this are the real, demonstrable and significant uncertainties about diagnosis and prognosis in both PVS and MCS".

"These have increased rather than decreased in the last 20 years and this is why continued court oversight is necessary", he added.

Care Not Killing is a UK-based alliance bringing together around 50 organisations - human rights and disability rights organisations, health care and palliative care groups, faith-based organisations groups - and thousands of concerned individuals.

For this reason, the family sought a declaration from the High Court that it wasn't mandatory to get permission to proceed from the Court of Protection.

Richard Gordon QC argued that common law or European Union human rights law should require that any case involving the withdrawal of such treatment should be subject to an application as to whether it is in the best interests of the patient.


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