$aving a $carce Re$ource: No Right to Artificial Nutrition and Hydration

In the Schiavo affair, there were no questions raised about providing artificial nutrition and hydration (ANH) if the patient herself wanted it to continue. The debate was whether to terminate ANH as her surrogate voiced her wishes. But when a national health service is paying the bill, there is a certain concern raised about providing ANH which was represented as the beginning of a slippery slope encouraging patients to request other “not appropriate” treatment. Leslie Burke, 45 was the patient involved. He has a degenerative brain condition and last July, in a British court, won the right to stop doctors withdrawing artificial nutrition or hydration treatment until he dies naturally. The original ruling was hailed as a breakthrough for the rights of terminally ill patients.

However the General Medical Council(GMC)which regulates medical practice in the U.K. and the Secretary of State for Health has appealed. The full article in the Scotsman.com on May 18, 2005 tells the whole story but here are excerpts.

"A right by patients to demand life-prolonging treatment has ‘very serious implications’for National Health Service (NHS) resources, appeal judges were told today. …
Backing a GMC bid to reverse the ruling, the health department claimed that if a right to ANH was established, patients would be able to demand other life-prolonging treatments.

Philip Sales, representing the Health Secretary, told a panel of three appeal judges… ‘A general right, as identified by the judge in the High Court), for an individual patient to require life-prolonging medical treatment has very serious implications for the functioning of the NHS. It may be interpreted as giving patients the right to demand certain treatments, contrary to the considered judgment of their medical team, that would lead to patients obtaining access to treatment that is not appropriate for them, and to inefficient (and unfairly skewed) use of resources within the NHS.’”

Do you think what is unsaid here may be the concern that the ANH would be keeping patients alive too long? The case is still pending in appeal. I will try to get a followup. ..Maurice.