This is especially the case in view of the implementation of the Human Rights Act. Confusion has arisen from the fact that guidance from the courts on withdrawing artificial nutrition and hydration specifically refers to patients in persistent vegetative state, without making reference to other serious conditions in which a decision to withhold or withdraw artificial nutrition and hydration might arise. With some conditions, such as advanced dementia or very severe stroke, a practice has developed where, in some cases, a decision is made that life-prolonging treatment, including artificial nutrition and hydration, is not a benefit to the patient and should not be provided or continued. The BMA does not believe that these cases should routinely be subject to court review but considers that there should be in place standard policies and guidance outlining the criteria and steps to be followed in reaching these decisions in all cases. As with all conditions, patients should be assured of uniformly high-quality assessment of their condition and of the potential treatment options available.
Guidelines help to ensure that proper and transparent procedures are followed.
This guidance attempts to document the type of factors which should be taken into account, the process which should be followed and the safeguards which should be in place to ensure that these decisions, and decisions to withhold or withdraw other life-prolonging treatments, are made appropriately. Last modified 24th April 2001.