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Airedale Nhs Trust V Bland Notes

Updated Airedale Nhs Trust V Bland Notes

Medical Law Notes

Medical Law

Approximately 1067 pages

Medical Law notes fully updated for recent exams at Oxford and Cambridge. These notes cover all the LLB medical law cases and so are perfect for anyone doing an LLB in the UK or a great supplement for those doing LLBs abroad, whether that be in Ireland, Hong Kong or Malaysia (University of London).

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Airedale NHS Trust v Bland [1993] AC 789

House of Lords

Held Lord Keith

  • The object of medical treatment and care is to benefit the patient.

    • It may do so by taking steps to prevent the occurrence of illness, or, if an illness does occur, by taking steps towards curing it.

    • Where an illness or the effects of an injury cannot be cured, then efforts are directed towards preventing deterioration or relieving pain and suffering

  • Given that existence in the persistent vegetative state is not a benefit to the patient, does the principle of the sanctity of life,

    • which it is the concern of the state, and the judiciary as one of the arms of the state, mean that treatment must be continued?

    • The principle is not an absolute one. It does not compel a medical practitioner on pain of criminal sanctions to treat a patient, who will die if he does not, contrary to the express wishes of the patient.

      • It does not authorise forcible feeding of prisoners on hunger strike.

      • It does not compel the temporary keeping alive of patients who are terminally ill where to do so would merely prolong their suffering.

        • On the other hand it forbids the taking of active measures to cut short the life of a terminally ill patient

    • The decision whether or not the continued treatment and care of a P.V.S. patient confers any benefit on him is essentially one for the practitioners in charge of his case.

      • The question is whether any decision that it does not and that the treatment and care should therefore be discontinued should as a matter of routine be brought before the Family Division for endorsement or the reverse.

Held Lord Goff

  • I start with the simple fact that, in law, Anthony is still alive. It is true that his condition is such that it can be described as a living death;

    • but as a result of developments in modern medical technology, doctors no longer associate death exclusively with breathing and heart beat,

    • and it has come to be accepted that death occurs when the brain, and in particular the brain stem, has been destroyed

    • Here, the fundamental principle is the principle of the sanctity of human life - a principle long recognised not only in our own society but also in most, if not all, civilised societies throughout the modern world

      • But this principle, fundamental though it is, is not absolute. Indeed there are circumstances in which it is lawful to take another man's life, for example by a lawful act of self-defence

      • We are concerned with circumstances in which it may be lawful to withhold from a patient medical treatment or care by means of which his life may be prolonged.

        • But here too there is no absolute rule that the patient's life must be prolonged by such treatment or care, if available, regardless of the circumstances

  • General Principles

    • First, it is established that the principle of self-determination requires that respect must be given to the wishes of the patient,

      • so that if an adult patient of sound mind refuses, however unreasonably, to consent to treatment or care by which his life would or might be prolonged,

        • the doctors responsible for his care must give effect to his wishes, even though they do not consider it to be in his best interests to do so.

    • But in many cases not only may the patient be in no condition to be able to say whether or not he...

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