Scottish Council on Human Bioethics

15 Morningside Road, Edinburgh EH10 4DP, Tel: 0131 447 6394

15 May 2005

Press release:

Scottish bioethics body indicates that the provision of food or fluids cannot be considered as a treatment but is part of basic healthcare.

The Scottish Council on Human Bioethics (SCHB) indicated, today, that in the light of the case being brought by the General Medical Council in the Court of Appeal, it did not believe that the provision of food and fluids should be considered as a medical treatment.

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to communicate their wishes" adding that "only in the last moments of a terminal illness could food and fluids be withdrawn or withheld should these be considered as futile and just a burden to the patient."

The Scottish Council on Human Bioethics is concerned that the intentional withdrawal and withholding of food and fluids when death is not imminent could be considered as a form of euthanasia if the actions directly result in the death of a patient. In addition, the Council is of the opinion that such actions may be in conflict with Article 2 [1] (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 1996 [2]. 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].

3. British Medical Association: Withholding and Withdrawing Life Prolonging Medical Treatment: http://www.bmjpg.com/withwith/ww.htm