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Withdrawing or withholding life prolonging treatment

BMJ 1999; 318 doi: (Published 26 June 1999) Cite this as: BMJ 1999;318:1709

A new BMA report fills an ethical vacuum

  1. Steven Luttrell, Consultant geriatrician and general physician
  1. Peckwater Centre, London NW5 2TX

    News p 1717

    The advice of the House of Lords about persistent vegetative state in the 1993 Anthony Bland case left some British doctors in an odd and uncomfortable position.1 Although decisions about the withholding or withdrawal of life prolonging treatment for a small number of younger patients with very severe cognitive and physical disability have to be reviewed by the courts in England, Wales, and Northern Ireland, many more frequent decisions to withdraw or withhold life prolonging treatment for older patients suffering strokes, dementia, or other serious illness continue to take place in the absence of explicit guidance and without any regulatory or monitoring process.

    The Bland case concerned the legality of withdrawing life prolonging treatment from Anthony Bland, a young man left in a persistent vegetative state after being crushed at the Hillsborough football stadium disaster. There is no doubt that the case substantially clarified the law relating to withholding or withdrawing life prolonging treatments and highlighted several important legal points: medical decisions for a mentally incapable patient should be made by the treating doctor in the best interests of the patient; if a decision to withdraw or withhold life prolonging treatment is …

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