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Airedale NHS Trust v Bland (1993): Study Guide
Core Principle: Withdrawing or withholding life-sustaining treatment from an incompetent patient is lawful if it's not in their best interests to continue the treatment. This does NOT mean the treatment is in their best interest, but rather that continuing is contrary to their best interest.
Facts of the Case:
Core Principle: Withdrawing or withholding life-sustaining treatment from an incompetent patient is lawful if it's not in their best interests to continue the treatment. This does NOT mean the treatment is in their best interest, but rather that continuing is contrary to their best interest.
Facts of the Case:
- Patient: Anthony Bland
- Cause: Suffered severe crush injuries in the Hillsborough disaster.
- Condition: Persistent Vegetative State (PVS) for 3.5 years with no hope of recovery.
- Legal Question: Was it lawful to withdraw life-sustaining treatment (specifically, artificial nutrition and hydration)?
- Lawful to Withhold/Withdraw: The court ruled it was lawful to withdraw treatment.
- Key Justification: It was not in Bland's best interests to prolong his life given his condition and lack of any prospect of recovery.
- No Absolute Obligation: Doctors do not have an absolute obligation to prolong life regardless of the circumstances or the patient's quality of life.
- "Best Interests" Test - A Negative Formulation: The test is more accurately described as "not being contrary to the best interests." The lack of positive benefit to the patient is key.
- Lord Mustill's Reasoning:
- Bland, in PVS, had no awareness and therefore couldn't be "affronted" by the withdrawal of treatment.
- Crucially, Bland had no best interests of any kind.
- While terminating life isn't inherently in his best interests, the justification for maintaining life support (his best interests being served by being kept alive) had also disappeared.
- Implication: This shifts the focus from a duty to preserve life at all costs to a consideration of whether the patient benefits from that continued life.
- Confirmation with Human Rights Act: NHS Trust A v M; B v H (2001) confirms that the Bland decision aligns with the Human Rights Act 1998 (although this alignment has been criticized).
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