Euthanasia and PVS Patients: When NHS can withdraw treatment of PVS patient?

The Supreme Court of the United Kingdom in a landmark case of Y (Patient) has clarified the law on euthanasia and persistent vegetative state. It held that it is not necessary for the doctors to always seek permission from the courts when withdrawing nutrition from patients in a persistent vegetative state (PVS). Under the guideline provided by the NHS England, the patients in PVS state

  • Are awake but show no signs of awareness. They may open their eyes, wake up and fall asleep at regular intervals and have basic reflexes. They’re also able to regulate their heartbeat and breathing without assistance
  • However, PVS Patients do not show any meaningful responses, such as following an object with their eyes or responding to voices. They also show no signs of experiencing any emotions.

A patient is deemed as in continuing – or persistent – vegetative state when he/she is in PVS state for more than four weeks. However, for a PVS the patient has to be more than six months in PVS state if it is caused by a non-traumatic brain injury, or more than 12 months if caused by a traumatic brain injury. Although a patient in a PVS state is highly unlikely to recover, however, it is not impossible.

In the case in question, the patient (Y) had suffered a heart attack and a subsequent ‘prolonged disorder of consciousness’, which included PVS and coma. Patient Y was in PVS state for 8 years and had no real or substantive hope for life and there was a consensus between doctors and Y’s family that treatment should be withdrawn.

The NHS asked the High Court to provide a declaration that in such cases, it is not necessary for the court to have to approve the withdrawal of nutrition. The High Court agreed but due to the serious implications of the ruling, the decision was appealed and came before the Supreme Court.

Lady Black, delivering the judgment referred to domestic law and the European Convention on Human Rights. She stated that there was no express legislation which said the withdrawal of nutrition for PVS patients had to be authorised by the court in circumstances similar Y’s.

The position of PVS patients is an interesting one that has been explored by case law. Airedale NHS Trust v Bland, concerned a victim of the Hillsborough disaster who had been in a persistent vegetative state for three and a half years. It was held that it was not unlawful for doctors to withdraw life support. Stopping such support was held to be an omission (not doing something) rather than a positive act (doing something) and was therefore legal. However, a positive act such as administering a drug to bring about the death of a patient (Euthanasia) was held to be unlawful and it is still unlawful in the United Kingdom to end your life through or by administration of drugs. However, few EU states including Switzerland and Holland allow Euthanasia.

The whole topic of euthanasia and PVS is highly controversial. For further assistance and guidance on medical law please speak to our expert medical lawyers instantly through our Instant Access Service. You can also instruct our lawyers for Full Representation on a fixed fee.

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This article is written by our legal content writer James Chalkley (LLB. LLM.). You can seek further advice from James by booking an appointment with him.

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