|Royal Court of Justice|
In the UK the Bland decision (February 1993) decided that a person who was unconscious and determined to be in a Persistent Vegetative State (PVS) could have their hydration and nutrition withdrawn with the intention of causing death. The Bland case concerned Tony Bland who experienced a profound cognitive injury in the Hillsborough disaster on April 15, 1989.
Since the Bland decision, many people in the UK who were deemed to be in a “PVS” state have been dehydrated to death, with the permission of the court.
The “M case” is a different because “M” is conscious even though the court was told that her responses are minimal and unreliable.
Justice Baker stated:
"I accept the evidence of the carers, who have far greater experience of living with M in recent years than do members of her family whose visits have become less frequent as time has gone by."Therefore “M” will not die by dehydration because it was determined that she had a “quality of life.”
"M does have positive experiences and …although her life is extremely restricted, it is not without pleasures, albeit small ones."
All forms of euthanasia reduce the value of certain human beings and deny equality and dignity to every human being.
To withdraw fluids and food from a person who is not otherwise dying, even if that person has a significant cognitive disability, is euthanasia because death is directly and intentionally caused by the withdrawal of basic care, that being fluids and food. Whether fluids and food are provided by a fork, a spoon or a tube, they represent a basic necessary of life that should be provided unless the person cannot assimilate or is actually nearing death.
For someone who is not otherwise dying, death by dehydration results in a painful death.
Whether “M” had a certain level of quality of life or not, the issue should be whether or not the decision of the court would have caused her death, rather than allow her to live until she dies a natural death.
The Bland decision was wrong because it did not differentiate between the definitions of treatment and care. If the Bland decision had determined that only medical treatment could be withdrawn, but not basic care, meaning the provision of the basic necessaries of life, then a line would have been drawn that it is not acceptable for society to cause a persons death, which is different than allowing a person to die. The result of the language contortion is that people are being dehydrated to death because they are living with a cognitive disability.
We applaud the decision by Justice Baker, while recognizing that until the Bland decision is redefined, that other cognitively disabled people, such as “M” will intentionally die by dehydration, even though they would not be otherwise dying.