News

Court allows second man the right to die

BMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6923.226 (Published 22 January 1994) Cite this as: BMJ 1994;308:226
  1. C Dyer

    A 24 year old man who has been in a persistent vegetative state in Britain for two and a half years after taking a drug overdose died last weekend, hours after the Court of Appeal sanctioned a decision by doctors not to replace his gastrostomy tube, which had become accidentally dislodged. Three judges ruled that doctors at Cossham Hospital in Bristol were entitled to conclude that the patient, named only as S, be allowed to die.

    The case was the first application concerning the right to die to reach the courts since the House of Lords authorised doctors last year to stop feeding Tony Bland, a survivor of the disaster at Hillsborough football ground. The appeal was brought on S's behalf by the official solicitor, Peter Harris, whose lawyers argued for a full inquiry into S's condition with independent experts and a full court hearing, as in the Bland case. But Sir Thomas Bingham, master of the rolls, and Lords Justices Waite and Peter Gibson upheld a High Court ruling last week that S, whose gastrostomy tube had been dislodged three days before, need not be kept alive.

    The judges said it was not in S's best interests for feeding to be reinstated. Sir Thomas said S had been diagnosed by the consultant in charge of his case as being in an irreversible persistent vegetative state, and he should be allowed to die. He added: “Here we have a careful, professional, and clearly a very thoughtful conclusion expressed by a consultant of the highest standing with knowledge of this patient over a period of years. It is an opinion shared by other doctors who have had the opportunity of seeing the patient over a period of years. It is an opinion no medical opinion contradicts.”

    Sir Thomas said that the case had raised “an acute dilemma.” S was “a fit, energetic, and sane young man” before he took the overdose, which caused brain damage. Despite all attempts at rehabilitation there had been no improvement and his mother had clearly wished over the past two years that he should be allowed to die, although his father was “equivocal.”

    The consultant treating him took the view that it would be “a criminal act” to reconnect the tube. Even before the accident the hospital trust had been considering applying for a declaration allowing him to die.

    Sir Thomas said that there was “widespread, understandable concern” about the implications of the Bland case and principles had been laid down to prevent abuse. But there seemed to be little doubt that S was in a vegetative condition with no prospect of recovery, and it was open to the doctors to conclude that it was in his best interests to be allowed to die.

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