Life or Death Cases

Dame Elizabeth Butler-Sloss, President of the†Family Division of the High Court, recently†addressed a conference on Withholding†Treatment. She said that the law had a crucial†role to play in resolving difficult decisions where†patients, families and doctors did not agree on†what would be in the best interests of a critically†ill patient. It was often the role of the law to set†limits on what was appropriate. She explained†that, at the end of the day, it is for the judge to†say whether the proposed management of the†case is lawful and for the doctors to go away and†decide what to do. In her words, "the buck stops†with the doctors and not with the judge".

There have been three recent high profile cases,†involving a terminally ill man and two seriously ill†babies. In July, Mr Justice Munby allowed Mr†Leslie Burke the right to decide for himself whether†he should receive artificial nutrition and hydration†after his congenital degenerative brain condition†had deteriorated to the extent that he could no†longer give or withhold consent. He considered that†there was a strong legal presumption in favour of†life. Treatment should only be withdrawn if certain†criteria were met, in particular that it would be†intolerable for treatment to continue.

In October, Mr Justice Hedley ruled that Charlotte†Wyatt should not be revived if she stopped breathing†again. Charlotte had chronic respiratory and kidney†problems, coupled with the most profound brain†damage that left her blind, deaf and incapable of†voluntary movement or response. In making his†ruling, the judge agreed with the views of†Charlotte's doctors as to what was in her best†interests and did not accept her parents'†submissions.

Dame Elizabeth herself presided over the case of†Luke Winston-Jones, who suffered from Edwards's†syndrome, a rare genetic disorder. She gave†permission for Luke's doctors to withhold treatment†by mechanical ventilation if his condition†deteriorated. That moment arrived on 12 November†and Luke died. His mother has now made a formal†complaint to the police about the refusal of the†doctors to carry out procedures that the family†believe would have prolonged Luke's life.

These cases show how difficult it is to apply the†established legal principles to individual cases.†Even if the principles are clear, the way in which†they are applied may be vigorously disputed by the†interested parties.

In the case of withholding treatment from a†child, the guiding principle is the child's...