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26 February 2004
The Scottish Council on Human Bioethics (SCHB) indicated, today, that it welcomed the judicial review of the General Medical Council guidelines concerning the conditions when doctors can stop artificial feeding and let a patient die.
This follows the case at the High Court brought by Mr. Leslie Burke who has a degenerative brain illness (cerebellar ataxia), concerning the rights of patients, unable to communicate their wishes, to nutrition.
Dr. Calum MacKellar, Director of Research of the SCHB, indicated that "nutrition is part of basic nursing care which should be given to every patient unable to communicate their wishes” adding that “only in the last hours of a terminal illness could this be considered as good medical practice if it is a burden to the patient".
The Scottish Council on Human Bioethics is indeed worried that the intentional withdrawal and withholding of food and fluids, directly resulting in the death of a patient, could be considered as a form of euthanasia and may be in conflict with Article 21 (Right to life) of the European Convention on Human Rights.
Scottish Legislation:
In Scotland, a Court has already authorised the withdrawal of artificial nutrition and hydration from a patient in Persistent Vegetative State (PVS) in 19962. But, unlike in England and Wales, the judgement made it explicitly clear that it was not necessary to apply to the Courts in every case where the withdrawal of artificial nutrition and hydration was proposed for a patient in PVS. In other words, though the Court of Session has confirmed its authority to consider such cases it did not make such consideration a formal requirement. The Lord Advocate further indicated that, where such authority has been granted by the Court of Session, the doctor would not face prosecution. This leaves open the possibility of prosecution should the doctor not seek authority from the Court of Session.3
1Article 2 (1) of the ECHR states that: "Everyone’s right to life shall be protected by law. No one shall be deprived of his life intentionally …."
2Law Hospital NHS Trust v Lord Advocate (1996)
3British Medical Association: Withholding and Withdrawing Life Prolonging Medical Treatment: http://www.bmjpg.com/withwith/ww.htm.