Green light to let patients die without asking judge

PATIENTS in a permanent vegetative state will be allowed to die without a judge’s approval after a landmark Supreme Court ruling.

Food and water can be withdrawn without asking a court – provided the patient’s doctors and family agree.

The ruling removes some of the confusion left by 25 years of arguments by doctors, lawyers and campaign groups over how and when to end the life of a patient with no hope of recovery.

However, it drew warnings that an essential safeguard protecting the lives of the most vulnerable people has been swept aside.

Anti-euthanasia campaigners involved in the case said in future life-and-death decisions ‘will be more influenced by those who have ideological or financial vested interests’.

Five Supreme Court justices made the unanimous decision in the case of a man in his 50s known only as Y, who in June last year suffered a cardiac arrest which left him permanently unconscious with severe brain damage.

Mr Y was kept alive by ‘ clinically assisted nutrition and hydration’ – liquid and nourishment tubes. Medical staff and his family agreed these tubes should be withdrawn.

A High Court judge approved this, but passed the decision on for further approval by Supreme Court justices.

Mr Y died in December last year from acute respiratory sepsis ‘Ideological interests’ before the case was decided. The ruling – which applies to patients in a persistent vegetative state and those who are described as ‘minimally conscious’ – appears to clarify arguments that have been running in the courts and Parliament since the early 1990s.

There are thought to be around 24,000 patients who could be affected by the ruling. The Court of Protection has ruled on these cases, but the process can be lengthy and expensive.

The Official Solicitor, whose office is charged with defending the interests of those who cannot do so themselves, advised the justices that court hearings are necessary to ensure that an independent voice can speak up for a patient in danger of death.

But Lady Black, giving judgment, said withdrawing nutrition did not violate the Human Rights Convention. She said the law hinged on whether it was in the patient’s best interests to receive treatment, and in some cases it was in their interest to withhold it. However, she urged families to still apply to court when doctors or relatives disagreed over a ‘proposed course of action’.

Dr Peter Saunders, of the Care Not Killing group, said scandals over unnecessary deaths – such as the now- withdrawn Liverpool Care Pathway – meant doctors should be legally supervised.

He warned allowing the braindamaged to die of dehydration was a ‘slippery slope’ as it costs the NHS £100,000 a year to look after vegetative patient.

Dr Tony Cole, of the Medical Ethics Alliance, advised people going into hospital to tell their families first if they do not want to die through dehydration. He described tube-feeding as ‘basic care’.

But the decision was welcomed by pressure group Compassion in Dying, which described it as ‘an important move towards more ‘person-centred care’ as their best interests can be acted on quickly rather waiting for a court ruling.