Starvation of incapacitated patients


Universe Column

by David Alton

It was deeply paradoxical that in the very week a shepherd was sentenced to six months in prison for not providing enough food and water for his sheep, some parliamentarians were insisting that it is lawful and ethical to starve to death an incapacitated patient. It reminded me that the last time the House of Commons debated euthanasia 77 of the MPs who voted for euthanasia voted against fox hunting. Only in Britain would we give more protection to the embryo of an animal that we deny to a human embryo.  It truly is a topsy turvey world.

The killing of sick patients began in 1989 with Tony Bland. His death clearly conflicted with the exercise of the duty of care for a patient and replaced it with a doctor’s judgement about whether a patient’s life is any longer worthwhile.

I have a curious letter from David Lammy who is a Minister in the Department of Health. Defending the Bland Judgement he claims that it is untrue to state that the purpose of withdrawing food and fluid from Tony Bland was to cause his death. What other purpose could it possibly have had?

The Bland case can be starkly contrasted with the case of one of my former constituents in Liverpool, Andrew Devine.  Andrew, like Tony Bland, went into a deep coma after being injured at the Hillsborough football match when 96 people died. The conditions of Tony Bland and Andrew Devine were identical.  Shortly after the Hillsborough tragedy I visited Andrew and his parents. As the years passed I have followed his progress. Last week Andrew’s mother told me that having been told by medics that, “Andrew will never be able to swallow or to eat food”, she felt that her son had “been written off”. She was told that it, would be a waste of resources to treat him”.

The medics also said that it would be clear within two years whether Andrew was going to make any progress. In fact, it took five years. They told his parents “nothing can be done” when quite a lot could be done and was done.  Against all the predictions Andrew now eats heartily and eats solids. Mrs Devine is adamant that “From our point of view it was a hard enough battle to fight for the things we needed without being offered the chance to do away with Andrew”.  She says, “Starving or dehydrating someone is an unpleasant death-you might as well give a lethal injection”.

Through their love and devotion Andrew’s parents found the Brain Injury Rehabilitation and Development Centre at Broughton, near Chester, not because they were referred there, but because they found it via a television programme. They took Andrew to London, to the Royal Hospital for Neuro-disability at West Hill in Putney and paid for his first course of treatment themselves.  Mrs Devine argues that the law needs to be strengthened because “economic pressures to free beds would be overwhelming; the pressure would be enormous”.  In reality, withdrawal of feeding, including oral feeding, is now being extended. In June 1999 the BMA published guidance on Withholding and Withdrawing Life-prolonging Medical Treatment, in which they considered it appropriate to withdraw tube feeding from,  To allow doctors to withdraw sustenance from patients with the purpose of ending their lives subverts the law of murder.

I have yet to hear a convincing explanation as to why nutrition and hydration, however so delivered, should be classified as medical treatment and not basic care. What medical ailment is being treated?  Since when has hunger or thirst been considered an illness? It has even been established in the case of animals that freedom from hunger and freedom from thirst constitute two of the five welfare considerations to which all domestic animals are entitled. Surely it is not unreasonable for the same criteria to be applied to human beings.  If starving a sheep to death is worth a six-month prison sentence, how can it ever be logical, ethical, or compassionate to justify the starving to death of a human being?