Legal Case Summary
Airedale National Health Service Trust v Bland [1993] AC 789
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 two years with no sign of improvement, whilst being kept alive by life support machines. 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 of the tube that was feeding him. This decision was then appealed to the House of Lords by the Solicitor acting on Bland’s behalf.
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 It was important to understand whether life support can ever be withdrawn from an individual who cannot provide medical professionals with informed consent on a specific issue.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. On the basis that there was no potential for improvement, the treatment Bland was receiving was deemed not to be in his best interests. It is not lawful to cause or accelerate death. However, in this instance, it was lawful to withhold life-extending treatment which in this instance was the food that Bland was being fed through a tube. Appeal dismissed.
Updated 19 March 2026
This case summary remains broadly accurate as a description of the House of Lords decision in Airedale NHS Trust v Bland [1993] AC 789. The core legal principles — that doctors must act in a patient’s best interests, that there is no absolute duty to prolong life, and that withdrawal of clinically assisted nutrition and hydration from a patient in a persistent vegetative state can be lawful — continue to represent good law.
However, readers should be aware of some important subsequent developments. The procedural requirement established after Bland — that court approval must be sought before withdrawing treatment from a patient in a persistent vegetative state or minimally conscious state — was significantly modified by the Supreme Court in An NHS Trust v Y [2018] UKSC 46. The Supreme Court held that, where clinicians and the patient’s family are in agreement and proper clinical and professional guidelines are followed, it is not always necessary to seek court authorisation before withdrawing clinically assisted nutrition and hydration. Court applications remain advisable in cases of doubt or dispute.
Additionally, the Mental Capacity Act 2005 now provides the primary statutory framework governing decisions about medical treatment for incapacitated adults in England and Wales, including the ‘best interests’ test under section 4. This statutory framework sits alongside and has developed the common law principles articulated in Bland. Readers relying on this case for current practice should consider it alongside the 2005 Act and subsequent case law.
