Withdrawing artificial feeding from children with brain damageBMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7003.464 (Published 19 August 1995) Cite this as: BMJ 1995;311:464
- Ronald E Cranford
- Professor of neurology University of Minesota, Department of Neurology, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN 55415 1829, USA
Is not the same as assisted suicide or euthanasia
Over the past few decades the American legal system has repeatedly confronted the legal dilemmas of stopping treatment for patients in a persistent vegetative state. From 1975 to 1990, 33 cases reached the higher courts. At least half of these concerned the withdrawal of artificial feeding. The British legal system has also had to address the same questions—first in the case of Tony Bland, crushed at Hillsborough football stadium, and now more recently in the case of Thomas Creedon, a 22 month old child who is said to be severely brain damaged and unable to hear, speak, or see.1 As legal systems are increasingly confronted with these cases, it is important to consider the basic medical, ethical, and legal principles that have unfolded over recent years.
The most critical factor from a medical perspective is when the persistent vegetative state (lasting longer than one month but potentially reversible) becomes permanent (irreversible). Recent American standards developed by the Persistent Vegetative State Taskforce discuss a range of 3-12 months, depending on the aetiology of the condition and the age of the patient.2 3 European authorities such as …