Article Text
Abstract
The question a judge has to ask in deciding whether or not life-sustaining treatment should be withdrawn is whether the continued treatment is lawful. It will be lawful if it is in the patient’s best interests. Identifying this question gives no guidance about how to approach the assessment of best interests. It merely identifies the judge’s job. The presumption in favour of the maintenance of life is part of the job that follows the identification of the question.
The presumption is best regarded as a presumption of law. It has long been recognised as part of the way in which the English law discharges its obligations under Article 2 of the European Convention on Human Rights (the right to life). But even if it is a ‘mere’ evidential presumption it cannot, on the facts of most cases involving applications for the withdrawal of life-sustaining treatment from patients in prolonged disorders of consciousness, be rebutted.
- decision-making
- end-of-life
- law
- prolongation of life and euthanasia
Statistics from Altmetric.com
Footnotes
Contributors I am the sole author of this article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; internally peer reviewed.
Read the full text or download the PDF:
Other content recommended for you
- Withdrawing life-sustaining treatment: a stock-take of the legal and ethical position
- It is never lawful or ethical to withdraw life-sustaining treatment from patients with prolonged disorders of consciousness
- When ‘Sanctity of Life’ and ‘Self-Determination’ clash: Briggs versus Briggs [2016] EWCOP 53 – implications for policy and practice
- Why I wrote my advance decision to refuse life-prolonging treatment: and why the law on sanctity of life remains problematic
- Deal with the real, not the notional patient, and don’t ignore important uncertainties
- Withdrawing clinically assisted nutrition and hydration (CANH) in patients with prolonged disorders of consciousness: is there still a role for the courts?
- Withdrawing treatment from patients with prolonged disorders of consciousness: the wrong answer is what the wrong question begets
- A matter of life and death
- ‘In a twilight world’? Judging the value of life for the minimally conscious patient
- The rebirth of medical paternalism: An NHS Trust v Y