A 34-year-old patient in a coma may be denied food and water, a UK High Court judge has ruled, stating that it is in the patient’s “best interests”. Dr Anthony McCarthy, of Bios Centre, London, responded to the decision, saying that it “builds on, and goes beyond, all that is wrong with current law and medical guidance on the treatment of those currently unable to make decisions”.

The patient, referred to as MSP, currently being kept in an artificial coma, is suffering from a treatable bowel condition. The treatment, in his case, is a stoma, an opening on the abdomen allowing for the evacuation of human waste into a colostomy bag.

Although the procedure was intended to be temporary, following an attempt at corrective surgery the doctors concluded that the stoma must be permanent. However, the patient had previously indicated that he thought that his life would not be worth living should the stoma remain, believing that he would be unable to find a job and find a romantic partner in such a condition.

The hospital is keeping the patient, who is not terminally ill, in an induced coma, and has sought a legal solution to fulfil the man’s assumed wish to die – the solution being to withdraw food and fluids in order to “compromise respiration”.

Dr Anthony McCarthy, of Bios Centre, responds to the judgement

Dr Anthony McCarthy, founder and director of the Bios Centre research institute in London, stated:

“This case builds on, and goes beyond, all that is wrong with current law and medical guidance on the treatment of those currently unable to make decisions. This patient is only unconscious because he is being deliberately kept so. The judgement lays huge stress on the patient’s advance directive, while admitting it was not “procedurally compliant” and noting that that the patient consented subsequently to a stoma in apparent contradiction of that directive, though in the hope it would not be permanent.”

Justice Hayden, in approving the hospital’s proposal, being, he claimed, in the patient’s “best interests”, justified the decision by asserting that, considering a written statement by the patient in February 2020, and evidence given by his mother, MSP “would unhesitatingly reject the striking artificiality of parenteral feeding”.

Justice Hayden also claimed, in relation to patient’s belief as to value of his future life with certain disabilities, that:

“It is not for me, or indeed anybody else, to critique those views or beliefs, but merely to identify them. They are a facet of [the patient’s] broader personality, the expression of which is integral to his own personal autonomy.”

Accordingly, he concluded that “this court is required to and does respect” the patient’s “exercise of his personal autonomy”.

However, Dr McCarthy has criticised the decision, arguing that, as a result of the court’s decision, “even nursing care is to be foregone in the name of… an imagined future which does not factor in the inherent dignity of all life, including life in a vulnerable condition”.

Dr McCarthy continued:

“The judgement endorses a philosophical presumption that ‘personal autonomy’ must be honoured even when particular decisions are suicidally motivated and so radically contrary to the goals of good medicine and justice. This feeds into the idea that self-assessments of life as ‘not worth living’ should be endorsed by doctors and judges who can act so as to eliminate such lives.

“It can take time to come to terms with a disability, though this happens frequently with appropriate support, as the research shows. Law and medicine become enemies of justice and health when they separate ‘best interests’ from the objective value of life, which is linked to the very human dignity which grounds respect for the patient him or herself.”

Watch Dr Anthony McCarthy’s “Reflections on euthanasia” here.