Dying man ecstatic after winning control of treatment

A TERMINALLY-ILL man was "ecstatic" yesterday after winning a groundbreaking ruling clarifying the rights of chronically-ill patients over life-sustaining treatment.

Leslie Burke, aged 44, of Mardale Road, Newton Estate, Lancaster, who has a degenerative brain condition, had taken his case to the High Court because he feared that his wish to go on living until he dies naturally could be overridden by General Medical Council guidelines.

A High Court judge in London announced that, although the bulk of the GMC's guidance on the withholding and withdrawing of life-prolonging treatments was a "compelling piece of work", he ruled parts of it were "unlawful".

"I am just ecstatic" said Mr Burke "It just seems like a great weight lifted off my shoulders."

"The judgment is a ground-breaking judgment," said Mr Burke's solicitor, Paul Conrathe.

"The court has accepted Mr Burke's concerns and decided that the patient, not the doctor, should determine whether it is in the best interests of the patient to receive, or to continue to receive, artificial nutrition and hydration.

"The court also declared that parts of the guidance issued by the General Medical Council on the Withholding and Withdrawal of Life-prolonging Treatment are unlawful.

"The guidance failed to emphasise adequately the heavy presumption in law of life-prolonging treatment. Crucially, the patient's request for such treatment was not just a factor to be taken into account when the doctor made the decision. The request had to be acted on.

"The judgment represents a significant shift in the balance of power away from the doctor to the patient.

"This has to be welcomed when a doctor's decision involves life and death consequences."

The GMC, which is actively considering an appeal, was given permission to do so.

In his lengthy written judgment, Mr Justice Munby said:

"Overall, it is a document whose contents - indeed whose whole approach - should greatly reassure patients and their relatives."

But he ruled that the legal content of the guidance was "properly vulnerable to criticism".

The first was that there was "unanswerable force" in the point that the emphasis of the guidance "is on the right of the competent patient to refuse treatment rather than on his right ... to require treatment".

He continued: "Secondly, the guidance fails sufficiently to acknowledge that it is the duty of a doctor who is unable, or unwilling, to carry out the wishes of his patient to go on providing the treatment until he can find another doctor who will.

"Thirdly, the guidance fails sufficiently to acknowledge the heavy presumption in favour of life-prolonging treatment and to recognise that the touchstone of best interests is intolerability."