Patient wins right to stop doctors withdrawing food and drink when he can no longer speak

Main Category: Nutrition / Diet
Article Date: 31 Jul 2004 - 10:00 PDT

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Leslie Burke, who has a degenerative brain condition (cerebellar ataxia), was concerned that doctors may one day withdraw food and drink when he could no longer speak. He has won a high court ruling which says the doctors cannot do that. Leslie wants to go on living for as long as he can, even when he loses his ability to communicate his wishes to people around him.

According to UK General Medical Council guidance on providing artificial nutrition, Leslie thought there might be situations in which life saving food and drink could be withdrawn, even if this went against his wishes. If his situation got so that he could not speak, the present guidance could allow doctors to remove food and drink.

Now the General Medical Council will have to re-write the guidance as a result of the new High Court ruling. This new ruling applies to all terminally ill patients and also patients who lose the ability to speak and communicate their wishes to doctors.

The General Medical Council can appeal, and says it is considering an appeal. Leslie Burke was over the moon after he heard the results of the new ruling. He said he had found the emotional strain quite painful, but says it has all been worthwhile.

Leslie believes doctors should be encouraged to focus on keeping people alive rather than helping them die. He says the patient is the one who should have the last say in all this. Leslie's says that feeding should never be withdrawn in his case - even if it were a matter of a couple of hours or days.

Current guidance allows doctors to asses whether a patient's condition is so poor, prognosis so hopeless, that continuing artificial nutrition and hydration would only serve to lengthen suffering. In cases like this, if the patient cannot communicate his/her wishes, the medical professionals could decide to withdraw artificial nutrition and hydration…..and allow the patient to die. In this situation the doctor would have to imagine what the patient would want in that situation, refer to the patient's written statements, liaise with relatives and make a decision.

Leslie was concerned that a doctor's decision would be subjective and not coincide with his own decision at the time. He wanted the guidance to make doctors go by what the patient had written down earlier - and only that.

Judge Mr Justice Munby said "The emphasis throughout is on the right of the competent patient to refuse treatment rather than on his right to require treatment. One can see the error creeping into the guidance in different ways……..It follows, in my judgment, that the claimant has in principle established his right to relief."

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