Legal permission will no longer be needed to end life support for patients in a permanent vegetative state when relatives and doctors agree it should be turned off, the UK’s highest court has ruled.
According to the Telegraph, the Supreme Court today (Monday) upheld a ruling that a man with an extensive brain injury should be allowed to die without his family going before a judge.
It means it will now be easier to withdraw food and liquid to allow such patients to die – when doctors and families and doctors are in agreement – without applying to the Court of Protection.
Campaign Director for the Care Not Killing Alliance, Dr Peter Saunders – who is also a leading light in the Christian Medical Fellowship and the homophobic Coalition for Marriage – today hit out at the decision.
In a press release, Care Not Killing said the ruling will affect up to 24,000 patients in the UK with permanent vegetative state (PVS) and minimally conscious state (MCS), meaning they can now be effectively starved and dehydrated to death if the medical staff and relatives agree that this is in their “best interests”.
People with PVS (awake but not aware) and MCS (awake but only intermittently or partially aware) can breathe without ventilators, but need to have food and fluids by tube (clinically assisted nutrition and hydration or CANH).
These patients are not imminently dying and with good care can live for many years. Some may even regain awareness. But if CANH is withdrawn, then they will die from dehydration and starvation within two or three weeks.
Until last year all cases of PVS and MCS have had to go to the Court of Protection before CANH could be withdrawn.
The press release continued:
This is concerning and disappointing news, because it removes an important safeguard from those without a voice.
Worryingly the Supreme Court has said that that there is no difference in principle between turning off a ventilator and removing a feeding tube as both are “forms of medical treatment” and patients with PVS and MCS should be treated in the same way as people with “severe stroke” a “degenerative neurological condition” or “other conditions with a recognised downward trajectory.
In making these declarations Lady Black and the Supreme Court have dramatically moved the goalposts on end of life decision-making. Once we accept that death by dehydration is in some brain-damaged people’s ‘best interests’ we are on a very slippery slope indeed.
There is a clear difference between turning off a ventilator on a brain-dead patient and removing CANH from a brain-damaged patient. PVS and MCS differ from conditions with a ‘downward trajectory’ because they are not progressive and do not in themselves lead inevitably to death.
The Supreme Court has set a dangerous precedent. 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.
Given that it costs about £100,000 per year to care for a person with PVS or MCS the potential ‘saving’ for the NHS could be as much as £2.4 billion annually if most seek to go down this route. Given the huge and growing financial pressure the health service is under is this really an additional pressure, no matter how subtle, we want to put medical staff and administrators under?