Withdrawal of treatment CASES
Withdrawal of treatment
In English medical law, withdrawal of treatment refers to the lawful discontinuation of life-sustaining medical intervention when it is no longer in a patient’s best interests. The issue raises ethical, legal, and human rights considerations.
Definition and Principles
The principle balances respect for life with recognition that treatment should not be continued where it is futile or burdensome. Decisions are guided by the patient’s best interests, autonomy, and dignity.
Requirements for Establishing
- Best interests: Courts apply an objective test considering medical, emotional, and welfare factors.
- Capacity: If the patient lacks capacity, decisions must comply with the Mental Capacity Act 2005.
- Judicial approval: Especially in cases involving withdrawal of artificial nutrition or hydration.
- Safeguards: The European Convention on Human Rights, particularly Article 2 (right to life), frames decision-making.
Practical Applications
A leading case is Airedale NHS Trust v Bland (1993), where the House of Lords authorised withdrawal of artificial feeding from a patient in a persistent vegetative state. Courts since have emphasised careful, individualised assessments.
Importance
Withdrawal of treatment highlights the intersection of law, medicine, and ethics. It ensures respect for human dignity while providing legal safeguards for patients, families, and medical professionals.
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A victim of the Hillsborough disaster, Anthony Bland, was left in a persistent vegetative state. The House of Lords ruled it was lawful for doctors to withdraw his life-sustaining artificial nutrition and hydration, as continuing treatment was not in his best interests. Facts Anthony Bland was a 17-year-old football supporter who suffered severe hypoxic brain damage during the 1989 Hillsborough Stadium disaster, crushing his chest and causing his lungs to collapse. This left him in a condition known as a persistent vegetative state (PVS). He was not ‘brain dead’ as his brain stem continued to function, and he could breathe
The Supreme Court ruled on the case of a terminally ill child whose parents wished to pursue experimental treatment abroad. The Court affirmed that moving the child to palliative care was in her best interests, prioritising her welfare and dignity over parental wishes. Facts The case concerned Zainab Abbasi, a six-year-old girl suffering from Niemann-Pick disease, a rare and fatal neurodegenerative condition. Medical experts at the Newcastle upon Tyne Hospitals NHS Foundation Trust were unanimous in their opinion that her condition was irreversible, progressive, and that she was nearing the end of her life. They concluded that further life-sustaining treatment
