Another contentious dehydration court case in the UK.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A case concerning the withdrawal of food and water from a middle aged Polish man living in the UK, known as RS, outlines clear lines between a family who want their son and brother, to live and possibly recover and his wife, who want him to die. RS had a significant cardiac arrest on November 6. (Link to the decision).

Doctors at University Hospital Plymouth NHS Trust, with agreement from the wife of RS, asked the court for permission to withdraw life-sustaining medical treatment, including nutrition and hydration from RS, providing him only palliative care. The birth family for RS opposed the court application.

On December 15, Justice Cohen ordered that:

i) It was not in RS's best interests to be given life sustaining medical treatment including nutrition and hydration and that such treatment could be lawfully discontinued;

ii) It was in his best interests to be given palliative treatment; and

iii) All care and palliative treatment given shall be provided so as to ensure that he retained the greatest dignity and suffered the least discomfort until such time as his life comes to an end.

On December 16, nutrition and hydration (food and water) were withdrawn from RS but then re-inserted on December 18 after RS's filed an appeal of the decision. The facts of the case were not in contention, the disagreement was based on RS and his Catholic faith. Justice Cohen stated:

His birth family said that his strong Catholic faith would mean that the sanctity of life would triumph over all other considerations. His wife said that from her conversations with him she can say with certainty that he would never have wanted to have been kept alive if he could not be helped and he would not have ever wanted to be a burden. His present state was causing great distress to his wife and their children, as it would be to him if he could feel it or express it.

Justice Cohen dismissed the appeal and on December 24, nutrition and hydration (food and water) were once again withdrawn from RS.

On December 27, the niece of RS filed an urgent appeal to Justice Holman based on the intention of appealing the case to the European Court of Human Rights (ECtHR) and the Polish government also sought interim relief in the case.

On December 28, the niece filed a substantive application to the ECtHR.

Justice Cohen then decided on December 30 to resume treatment for RS until January 7 at 4 pm based on several factors, including a change in the medical condition (he is breathing on his own) and the possible hearing of the case by the ECtHR and the involvement of the Polish government.

Discrimination.

Article 25 of the Convention on the Rights of Persons with Disabilities states:

Parties recognize that persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination on the basis of disability

25f states: Prevent discriminatory denial of health care or health services or food and fluids on the basis of disability.

The Convention on the Rights of Persons with Disabilities finds that denying a person with disabilities food and fluid is a form of discrimination. RS is a person with a disability.

Is this an issue of euthanasia?

RS is not otherwise dying and will continue to live if he receives basic care, such as food and water, warmth, hygiene, etc. He breathes on his own and has shown improvement since his cardiac arrest.

There is a clear distinction between someone who is dying and someoone who is not otherwise dying. Since RS is not otherwise dying, denying him basic care, including food and water, would cause him to die of dehydration. Morally speaking, this is the same as euthanasia, because the cause of death is the intentional withholding of basic care.

Legally speaking this is not euthanasia. Bioethicists and legal decisions have defined the provision of nutrition and hydration (food and water) as medical treatment. This is a bizarre definition since food and water are not medications, but rather basic necessities of life, nonetheless, this is the reality.

There are many cases, similar to RS, that do not receive any media attention. The best outcome, in this situation, is to fulfill the request by the Polish government and send RS back to Poland where he can receive treatment and care.

I hope that this is done.