July 30, 2018 (Society for the Protection of Unborn Children) – The Supreme Court has ruled that doctors can withdraw food and fluid from brain-damaged patients without going to court – if the patient's family are in agreement.

The Care not Killing (CNK) Alliance, of which SPUC is a key member, has expressed concern and disappointment that a key safeguard has been removed from vulnerable patients.

Best interests?

The ruling will effect up to 24,000 patients 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 in these states can breathe without ventilators, but need to have food and fluids by tube (clinically assisted nutrition and hydration or CANH). Until last year, all requests to remove CANH had to go before the Court of Protection. Now, the Supreme Court has upheld an earlier ruling by the High Court that where relatives and medical staff agree that withdrawal of CANH is in the patient's 'best interests', the Court of Protection need not be involved.

Slippery slope

CNK Campaign Director Dr Peter Saunders said that the ruling "removes an important safeguard from those without a voice."

He also slammed the Supreme Court's ruling that there is no difference in principle between turning off a ventilator and removing a feeding tube as both are 'forms of medical treatment'

"In making these declarations Lady Black and the Supreme Court has dramatically moved the goalposts on end of life decision-making," he said. "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."

Thousands of people in danger

Dr Saunders also spelt out how the ruling puts the lives of the thousands of brain damaged people at risk, especially at a time when medical advances are being made in the treatment of severe brain conditions. "The Supreme Court has set a dangerous precedent," he said. "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."

Published with permission from the Society for the Protection of Unborn Children.