United Kingdom court ruling seen as landmark in right-to-die cases

When both medical staff and the patients’ family agree life support can now be ended without seeking court permission

Supreme Court Justice, Lady Black, recognised in her ruling that "no life is to be relinquished easily".

This means that, when the patient's family and a medical team are in agreement, it will now be easier to withdraw food and liquid, to allow people with a prolonged disorder of consciousness to die naturally.

Such cases can be costly and take months or years to resolve.

The ruling was made in the case of a banker, identified only as "Mr Y", who suffered a heart attack in June 2017 at the age of 52. Once we accept that death by dehydration is in some brain-damaged people's "best interests" we are on a very slippery slope indeed.

He never regained consciousness, and was being fed with clinically-assisted nutrition and hydration (CANH).

Is Court Intervention Essential Here?

Medical staff will now be able to remove feeding tubes in such cases without having to apply to the Court of Protection, under previous laws.

Lady Black, heading a five-judge bench in the case, said an agreement between families and doctors was sufficient safeguard to ensure "public confidence".

The High Court granted that declaration and gave permission to appeal directly to the Supreme Court.

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

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What Did the Supreme Court Decide?

Advocacy group Care Not Killing said that it had "dramatically moved the goalposts on end of life decision-making". While the Human Rights Convention, which became made law in the United Kingdom through the Human Rights Act (1998), protects our right to life as one of our most fundamental rights, it doesn't talk about our right to a good death.

Prior to the Supreme Court ruling (pdf) on July 30, each case was referred to a judge before artificial nutrition and hydration could be withdrawn.

Assisted death has been a tricky issue for human rights, both here and overseas. "This would cross the line from reasonable withdrawal of inappropriate treatment into the realm of passive euthanasia".

Dr Philip Howard, immediate past president of the Catholic Medical Association, cited Pope John Paul II, who in 1994, described the administration of food and water, even when "provided by artificial means" as "a natural means of preserving life".

What Do People Think About This Decision?

'If the provisions of the MCA 2005 (Mental Capacity Act) are followed and the relevant guidance observed, and if there is agreement upon what is in the best interests of the patient, the patient may be treated in accordance with that agreement without application to the court'.

The Supreme Court in considering the case of Mr Y addressed whether this practice amounted to a legal obligation. Taking these decisions away from the Court of Protection removes an important layer of legislative scrutiny and accountability and effectively weakens the law.

"It will make it more likely that severely brain-damaged patients will be starved or dehydrated to death in their supposed "best interests" and that these decisions will be more influenced by those who have ideological or financial vested interests in this course of action".


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