End of life decisions

The Supreme Court has recently ruled that it will now be easier for medical staff to withdraw food and liquid from patients who are in a permanent vegetative state (PVS), thereby accelerating their deaths.

For many years, provided doctors and relatives were in agreement, doctors have been able to withdraw some treatments, eg dialysis, which have hastened their patient’s death. However, the removal of food and water (considered to be essential for life to endure) were viewed differently. 

Even if the patient’s doctors and relatives were in agreement that feeding tubes should be withdrawn, they still had to seek a court order to take this step. Such court actions can take months to reach a conclusion and the legal costs to health boards can run into tens of thousands of pounds (money which would be better spent in the NHS). As a consequence, health boards have been reluctant to take this step and patients in permanent vegetative states have lingered on life support for many, many years.

However, the Supreme Court has now determined that the courts need not be involved where doctors and families are in agreement and it is in the best interests of the patient for nutrition to be withdrawn. It is hoped that this ruling will help relieve stress for families who find themselves in very tragic situations.

Where the medics and families are in dispute about the withdrawal of food and water, it will still be possible for an application to be made to the court for a ruling as to what is in the best interests of the patient. Our Litigation team would be able to assist with representing the patient’s or family’s interests in such an application.

It is also possible for individuals to give advance directions to their doctors and relatives in the form of a “living will” (or “Advance Medical Directive”). This provides their instructions as to how they wish to be looked after or when their care should be withdrawn in the event of serious/terminal illness or a PVS. The extent to which these instructions will be taken account of will depend on several factors including evidence that they represent an informed choice. Should you wish advice about the preparation of such a document, please contact our Private Client team.