Withdrawing life-sustaining treatment: a stock-take of the legal and ethical position

Author:

Ruck Keene Alexander Charles EdwardORCID,Lee Annabel

Abstract

This article, prompted by an extended essay published in the Journal of Medical Ethics by Charles Foster, and the current controversy surrounding the case of Vincent Lambert, analyses the legal and ethical arguments in relation to the withdrawal of life-sustaining treatment from patients with prolonged disorders of consciousness. The article analyses the legal framework through the prism of domestic law, case-law of the European Court of Human Rights and the Convention on the Rights of Persons with Disabilities, and examines the challenge to the ethical consensus made by Foster. It concludes that the right approach remains a version of the approach that has prevailed for the last 25 years since the decision in Airedale NHS Trust v Bland[1993] AC 789, refined to reflect that that there is now, and rightly, a much more limited place for judgments made about the ‘burden’ of treatment or the quality of life enjoyed by the person made on the basis of assumptions about that person as a category as opposed to investigation of that person as an individual human being.

Publisher

BMJ

Subject

Health Policy,Arts and Humanities (miscellaneous),Issues, ethics and legal aspects,Health(social science)

Reference20 articles.

1. It is never lawful or ethical to withdraw life-sustaining treatment from patients with prolonged disorders of consciousness

2. British Medical Association/Royal College of Physicians. Clinically-assisted nutrition and hydration (CANH) and adults who lack the capacity to consent Guidance for decision-making in England and Wales, 2018.

3. Aintree University Hospitals NHS Foundation Trust v James [2013] UKSC 67. 2013.

4. Essex Chambers. Aintree University Hospitals NHS Foundation Trust v James, 2013. UKSC 67 at paragraph 39.

5. An NHS Trust v Y (Intensive Care Society & Ors intervening) [2018] UKSC 46. 2019.

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