Coma man should be allowed to die, appeal judges say

TONY BLAND, the Hillsborough football disaster coma victim, would be shown greater respect 'by being allowed to die and be mourned by his family, than by being kept grotesquely alive', the Court of Appeal ruled yesterday.

In a rare move, the judges justified on moral and ethical grounds their decision to allow doctors to end the artificial feeding which for three years has kept the 21-year- old football fan alive.

Lord Justice Leonard Hoffman said the case had aroused much public concern and debate about the sanctity of life: 'This is not an area in which any difference can be allowed to exist between what is legal and what is morally right. The decision of the court should be able to carry conviction with the ordinary person as being based not merely on legal precedent but also upon acceptable ethical values.'

The judges emphasised that the case was not about euthanasia, or playing God, or about 'putting down' the old and infirm, the mentally defective or the physically imperfect. 'It has nothing to do with the eugenic practices associated with fascist Germany,' Sir Thomas Bingham, the Master of the Rolls, said. The issue was solely confined to whether it was lawful to stop artificial feeding and antibiotic treatment of 'an insensate patient with no hope of recovery'.

Mr Bland suffered crush injuries during the 1989 disaster which starved his brain of oxygen and sent him into a 'persistent vegetative state' from which medical experts say he will never recover.

Lord Justice Hoffman described his contorted limbs and reflex movements which cause him to vomit and dribble. Mr Bland's parents, Allan and Barbara, were not in court to hear the judge add: 'Of all this and the presence of members of his family, who take turns to visit, Anthony Bland has no consciousness at all. The parts of his brain which provided him with consciousness have turned to fluid . . . His body is alive, but he has no life in the sense that even the most pitifully handicapped but conscious human being has a life.'

The advances of modern medicine which now permitted him to be kept in this state for years 'therefore face us with fundamental and painful decisions about life and death which cannot be answered on the basis of normal everyday assumptions'.

The law had to reassure people that not only did the courts have full respect for the sanctity of life, but also that they did not pursue the principle to the point of sacrificing other values such as personal privacy and dignity.

He dismissed argument centred on quality of life and making God- like decisions about whether a life was worth living 'because the stark reality is that Anthony Bland is not living a life at all. None of the things that one says about the way people live their lives - well or ill, with courage or fortitude, happily or sadly - have any meaning in relation to him.'

He said emotive phrases of 'starving' to death only complicated an already difficult problem.

The three judges were dismissing an appeal by David Venables, the Official Solicitor, who represents the interests of people like Mr Bland who cannot speak for themselves. Because of the importance of the case - not only for the other more than 1,000 victims of PVS - he argued that to stop feeding amounted to murder and a breach of a doctor's duty of care, so that the law can be clarified. Yesterday's decision is to go the Lords for a definitive ruling.

The Master of the Rolls said Mr Bland would want to be remembered as a 'cheerful, carefree, gregarious teenager, and not an object of pity . . . Doing my best to look at the matter through his eyes . . . I cannot conceive what benefit his continued existence could be thought to give him.'

Lord Justice Butler-Sloss said: 'He has the right to be respected. Consequently he has the right to avoid unnecessary humiliation and degrading invasion of his body for no good purpose.' On the criminal law, she said Mr Bland's case was different from that of Dr Nigel Cox, who was convicted of attempting to murder a terminally ill patient by giving a lethal injection. What Dr Cox did was an external and intrusive act which was not in accordance with his duty of care. But withdrawal of artificial feeding would simply place the patient in the position he would have been in before the feeding tube was inserted.

The judges agreed that future cases of patients like Mr Bland should each be referred to the High Court as a safeguard. Lord Justice Butler-Sloss said: 'The rapid advances of medical technology create problems which may require the intervention of the courts from time to time.'

Law report, page 30

(Photograph omitted)