« Cosmetic Gynecology. | Main | New CAP Subsidies. »

May 17, 2005

Right or Requirement to Die?

Alongside  the debate on assisted suicide, living wills, the right to demand withdrawal of treatment, there seems to be another one going on as well:

A terminally ill man who fears he will be condemned to die of thirst - fully conscious but unable to swallow - heard doctors' leaders argue in court yesterday that allowing patients to decide on their own treatment was not in their best interests.

Under guidance issued by the GMC in 2002, doctors may stop feeding and hydrating a patient by artificial means if they judge that the "patient's condition is so severe, or the prognosis so poor, that providing artificial nutrition or hydration may cause suffering, or be too burdensome in relation to the possible benefits".

Last July, Mr Burke won a declaration that this part of the guidance was unlawful because it failed to recognise "the heavy presumption in favour of life-prolonging treatment".

The court's decision was based on English common law and the European Convention on Human Rights. Mr Justice Munby ruled that a patient who was competent - or who had left valid instructions - could insist that doctors fed him artificially.

Yesterday, Philip Havers, QC, for the doctors' governing body, said the judge's ruling had effectively "extended the reach of patient autonomy" and redefined the test as to what treatment was in a patient's best interests.

Mr Havers said there was "no evidence" that any member of the medical profession was likely to treat Mr Burke, or apply the GMC's guidance, in the way that he feared.

There was nothing to suggest that Mr Burke would not be given artificial nutrition and hydration when he needed it, "which, hopefully, will be many years hence".

In written submissions, however, Mr Havers told the Master of the Rolls, Lord Phillips, sitting with Lords Justices Waller and Wall, that Mr Justice Munby's conclusions put doctors in an "impossibly difficult position".

The result would be that a patient could require a doctor to provide a form of treatment that the doctor considered of no clinical benefit if not harmful.

"Such a conclusion is not in the best interests of patients," said Mr Havers - both as a matter of principle and because it would gravely undermine the "therapeutic partnership based on joint decision-making between doctors and patients".

Now I may havegot this slightly wrong but I think that lawyer is arguing that the patient has no right to insist upon treatment that keeps him alive. Only the doctor can decide what is appropriate.

What a wonderful world we’re building, eh? You can ask to die but not to live.

May 17, 2005 in Health Care | Permalink


TrackBack URL for this entry:

Listed below are links to weblogs that reference Right or Requirement to Die?:


My sentiments entirely. I haved watched these developments with incredulity over the last 15 odd years. This is nothing that wouldn't surprise me about this country any more.

Posted by: esbonio | May 17, 2005 9:12:30 AM

"or be too burdensome in relation to the possible benefits": WHO finds it burdensome; to WHOM do the benefits obtain? Clear thinking, please.

Posted by: dearieme | May 17, 2005 2:45:04 PM