Are British doctors obliged to withdraw life support if requested by a patient?
This question was raised by Iain Brassington of the University of Manchester, in response to the introduction of the Conscientious Objection (Medical Activities) Bill in the British parliament.
The bill would protect health care professionals who conscientiously object to a range of controversial medical procedures.
Brassington suggested that certain clauses of the proposed legislation may conflict with extant civil and criminal law, under which it is unlawful to fail to withdraw treatment (including life-sustaining treatment) from a competent patient who no longer consents to it, or from a patient who lacks capacity if treatment is no longer in her best interests.
Yet in a response post to Brassington, University of Strathclyde law lecturer Mary Neal said that there was no tension between the proposed bill and existing law.
First, Neal observed that existing GMC guidance permits a conscientious objection to withdrawal of life-sustaining treatment. Paragraph 79 of the GMC’s guidance Treatment and care towards the end of life: good practice in decision making (2014) states that doctors can object to withdrawing treatment if their “religious, moral or other personal beliefs” lead them to do so.
“Doctors, at least, are already subject to guidance that tells them they can opt out of involvement in the withdrawal of life-sustaining treatment”, Neal writes.
Second, Neal observes that extant case law requiring the withdrawal of treatment of consenting patients applies to Trusts rather than to individual doctors:
When a competent patient indicates that she no longer consents to life-sustaining treatment [...]continued treatment is unlawful...But this obligation belongs to the Trust...If an individual professional notifies her employer that she has a belief that forbids her from performing the act of withdrawal (switching off a life support machine, or disconnecting a feeding tube, for example), it is incumbent upon those with management responsibility to assign the task to someone else who has no such objection.
The Conscientious Objection (Medical Activities) Bill has progressed passed a second reading in the House of Lords, and will now go before a committee.
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