Legal Case Summary
Airedale National Health Service Trust v Bland [1993] UKHL 17
Medical treatment – Ending treatment in absence of informed consent
Facts
Bland was injured in the Hillsborough disaster when he was seventeen and a half years old and was left in a persistent vegetative state. He remained in this state for over three years with no sign of improvement, whilst receiving artificial nutrition and hydration. Bland could breathe by himself but required feeding via a tube and received full care. The doctors that were treating Bland were granted approval to remove the tube that was feeding him. This decision was then appealed to the House of Lords by the Official Solicitor acting on Bland’s behalf.
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Issues
A patient that is in a persistent vegetative state cannot withhold or offer consent for treatment. This requires the doctors to act in the best interests of the patient, which in this case was whether the continuation of Bland being on life support was in his best interests. It was important to understand whether life support can ever be withdrawn from an individual who cannot provide medical professionals with informed consent on a specific issue.
Decision/Outcome
Doctors have a duty to act in the best interests of their patients but this does not necessarily require them to prolong life. In Bland’s case there was no prospect of recovery of consciousness, and continuing the artificial feeding regime conferred no therapeutic benefit. The House of Lords treated artificial feeding as part of medical treatment and care which could lawfully be discontinued in those circumstances.
The court distinguished withdrawing such treatment from taking active steps to kill a patient, such as administering a lethal injection. Withdrawal was treated as an omission: where there was no duty to continue the treatment, discontinuing it was not an unlawful killing. This did not give doctors a general power to end the lives of patients who could not consent. Appeal dismissed.
Further citations: [1993] AC 789; [1993] 2 WLR 316; [1993] 1 All ER 821; [1993] 1 FLR 1026; [1993] 4 Med LR 39; (1993) 12 BMLR 64; [1993] Fam Law 473; [1994] 1 FCR 485.
Judgment: House of Lords, 4 February 1993.
