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Report No. 196

(8A) Practice Note by Official Solicitor: 1994(2) All ER 413:

Withdrawal of treatmen.- Insensate patien.- patient in persistent vegetative state. Sanction of High Court required before treatment terminate.- confirmation of diagnosis.

This Practice Note was issued by the Official Solicitor mentioning the procedure to be followed while seeking declaratory relief. The formal of the declaration is also given in the Practice Note.

The Note states that termination of artificial feeding and hydration for patients in a PVS requires, virtually in all cases, sanction of High Court Airedale and Frenchay Healthcare NHS Trust vs. S: 1994(2) All ER 403 are quoted. (That it need not be in all cases was laid down by the Court of Appeal, in Re Burke, (2005) EWCA (Civ) 2003)

The diagnosis: The Medical Ethics Committee of British Medical Association issued guidelines in July 1993. A PVS diagnosis should not be confirmed unless the patient is in that state for 12 months. Such a decision must be preceded by rehabilitative measures such as arousal programmes. (Airedale and Report of House of Lords Select Committee on Medical Ethics HC paper (1993-94) 21-1).

Procedure for application to court is detailed on the basis of procedure indicated by HL in F v. West Berkshire Health Authority: 1989 83(2) All ER 545 (HC) and Official Solicitor's Practice Note of May 1993: 1993 (3) All ER 222. (The form of declaration to be asked is also set out in the present Practice Direction).

Parties: Applicants may be either next of kin or relevant Area Health Authority/NHS Trust/(which in any event ought to be a party). The views of next of kin are very important and should be made known to court. The Official Solicitor should be invited to act as guardian ad litem of the patient.

The evidence: There should be at least two neurological reports on the patient, one of which will be commissioned by the Official Solicitor. Other medical evidence, such as evidence about rehabilitation or nursing care, may be necessary.

The views of the patient if previously expressed, either in writing or otherwise are important and the High Court may determine the effect of a purported advance directive as to future medical treatment (Re T: 1992 (4) All ER 649).

Medical Treatment to Terminally Ill Patients (Protection of Patients and Medical Practitioners) Back

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