Patient loses ‘right-to-food’ battle

The General Medical Council has won its appeal against a ruling, which allowed a terminally ill man to stop doctors from withholding food and drink from him.

Lesley Burke, 45, suffers from cerebellar atraxia, a degenerative brain condition. The condition will eventually lead to the loss of the power of speech and control of limbs, but it does not affect mental faculties.

Mr Burke, from Lancaster, had feared that doctors would be able to withdraw his feeding tube after he was unable to speak. Last July, he won a landmark court ruling, preventing doctors from withholding artificial nutrition from him.

The case was viewed as a groundbreaking decision for the rights of terminally-ill people.

However, the GMC argued that this placed doctors in an “impossibly difficult position” and could force doctors to continue to provide treatment, which no longer had any benefit and could even be harmful.

Speaking after the appeal, Mr Burke said: “Obviously I am disappointed that I have not got all that I wished for.”

He was refused permission to take the case to the House of Lords, but he will be able to petition the House for a hearing.

The GMC said that it hoped Thursday’s decision would reassure Mr Burke that he would receive the treatment he needs, including artificial nutrition and hydration, and that nothing in its guidance prevents this.

Professor Sir Graham Catto, President of the GMC, said: “Patients should be reassured by this judgement, which emphasises the partnership needed to resolve end of life issues. Our guidance makes it clear that patients should never be discriminated against on the grounds of disability. And we have always said that causing patients to die from starvation and dehydration is absolutely unacceptable practice and unlawful. Today the Court has reinforced our position on these points. In the light of the judgement we shall look at what further steps we can take to explain and promote good practice in this area.”

The British Medical Association (BMA) also welcomed the decision. Dr Vivienne Nathanson, the BMA’s Head of Ethics and Science, said: “We hope the judgment will help patients, their families and doctors understand good practice and decision-making in this area. A decision about when to curtail active interventions for people who are dying or seriously ill is one of the hardest choices that patients, families and doctors make. It is absolutely essential for all involved that the law and professional guidance is clear. We very much welcome the clarification provided by today‚s judgment.”

However, the Disability Rights Commission (DRC) expressed concerns about the possible implications of the ruling.

Bert Massie, Chairman of the DRC, said: “This ruling means that doctors will have to listen to whether you do, or do not want, life-prolonging treatment if you can make your choices clear. However, that safeguard, for the most fundamental of choices, has not been upheld for the most vulnerable people of all – those who cannot express their wishes.

“Many disabled people fear that some doctors make negative, stereotypical assumptions about their quality of life. This ruling will not allay many of their fears. If you become incompetent someone else can still decide what is burdensome and what is in your best interests."

(KMcA/SP)