Airedale NHS Trust v Bland [1993] 1 All ER 821
Airedale NHS Trust v Bland [1993] 1 All ER 821
HOUSE OF LORDS
LORD KEITH OF KINKEL, LORD GOFF OF CHIEVELEY, LORD LOWRY, LORD
BROWNE-WILKINSON AND LORD MUSTILL
14, 15, 16 DECEMBER 1992, 4 FEBRUARY 1993
A 21-year-old patient, AB, in the care of the applicant health
authority had been in a persistent vegetative state for three and a half
years after suffering a severe crushed chest injury which caused
catastrophic and irreversible damage to the higher functions of his
brain. He was being fed artificially and mechanically by a nasogastric
tube which had been inserted through his nose and down into his stomach.
The unanimous opinion of all the doctors who had examined him was that
there was no hope whatsoever of recovery or improvement of any kind in
his condition and that there was no reasonable possibility of his ever
emerging to a cognitive sapient state from his existing persistent
vegetative state in which, although he continued to breathe unaided and
his digestion continued to function, he could not see, hear, taste,
smell, speak or communicate in any way, was incapable of involuntary
movement, could not feel pain and had no cognitative function. In those
circumstances the consultant geriatrician at the hospital where AB was
being cared for reached the clear conclusion that it would be
appropriate to cease further treatment, which would involve withdrawing
the artificial feeding through the nasogastric tube and declining
antibiotic treatment if and when infection appeared. If such a course
were adopted the lack of sustenance would bring to an end the physical
functioning of AB’s body within one to two weeks and he would die by
starvation. The consultant’s view was supported by other distinguished
medical experts. The health authority responsible for AB’s care
applied to the court for declarations that it and the responsible
physicians could lawfully discontinue all life-sustaining treatment and
medical support measures designed to keep AB alive in his existing
persistent vegetative state including the termination of ventilation,
nutrition and hydration by artificial means and that they could lawfully
discontinue and thereafter need not furnish medical treatment to him
except for the sole purpose of enabling him to end his life and die
peacefully with the greatest dignity and the least pain, suffering and
distress. The plaintiffs’ action was supported by the parents and
family of AB. The judge granted the declarations sought. The Official
Solicitor appealed to the Court of Appeal, which affirmed the judge’s
decision. The Official Solicitor appealed to the House of Lords,
contending that the withdrawal of life support was both a breach of the
doctor’s duty to care for his patient, indefinitely if need be, and a
criminal-act.
