Medical Treatment: Decisions and the Law

15. Withdrawal and Withholding of Treatment

Co-authored by Michael Mylonas QC, Jamie Mathieson and Elizabeth Fox.

Contents

  • A Introduction  15.1
  • Prolonged disorders of consciousness (coma/VS/MCS) 15.2
  • B Vs: Legal principles 15.8
  • The Bland decision  15.9
  • Extending Bland to other cases  15.12
  • The problem with ‘act’ and ‘omission’ 15.15
  • Continuing treatment as an assault 15.16
  • European Convention on Human Rights 15.17
  • European Convention on Human Rights: the Lambert decision 15.23
  • MCS: legal principles 15.29
  • Withdrawal of treatment in MCS 15.30
  • C Diagnosis of PVS and MCS 15.40
  • Current approach to diagnosis 15.44
  • ‘Permanent’ VS 15.49
  • Diagnosis of a minimally conscious state 15.51
  • Summary 15.52
  • D Role of the family  15.53
  • E Is an application to court required?  15.55
  • When court approval is required to withhold nutrition and hydration 15.56
  • Advance decisions/prior consent 15.58
  • F Application to court 15.59
  • Confidentiality  15.60
  • Evidence  15.61
  • G Emergency cases  15.68
  • Critique of Frenchay approach  15.69
  • H Doctors who disagree in principle 15.70
  • I Children 15.71
  • Welfare of the child  15.72
  • Decision making in the absence of pain 15.75
  • Dignity 15.76
  • The procedural position in applications relating to children 15.81
  • Social media 15.82
  • Medical experts  15.83
  • Funding  15.84
  • J Mediation  15.85
  • K Conlusion  15.86
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