Airedale NHS Trust v Bland: CA 9 Dec 1992

The official Solicitor appealed against a decision that doctors could withdraw medical treatment including artificial nutrition, from a patient in persistent vegetative state.
Held: The doctors sought permission to act in accordance with recommended medical practice. Agreement was universal that there was no prospect of the patient’s improvement, nor any purpose in continued treatment. The purpose of medical treatment was to act for the benefit of the patient, and no benefit was being derived. The inviolability of life is not an absolute, and hear no direct interference was proposed, but rather the withdrawal of support. The appeal failed.
Hoffmann LJ said: ‘we have a strong feeling that there is an intrinsic value in human life, irrespective of whether it is valuable to the person concerned or indeed to anyone else. Those who adhere to religious faiths which believe in the sanctity of all God’s creation and in particular that human life was created in the image of God himself will have no difficulty with the concept of the intrinsic value of human life. But even those without any religious belief think in the same way. In a case like this we should not try to analyse the rationality of such feelings. What matters is that, in one form or another, they form part of almost everyone’s intuitive values. No law which ignores them can possibly hope to be acceptable.’
References: [1993] 2 WLR 316
Links: lip
Judges: Sir Thomas Bingham MR, Butler-Sloss and Hoffmann LJJ
Jurisdiction: England and Wales
This case cites:

  • Cited – In re T (Adult: Refusal of Treatment) CA 1992
    A patient’s right to veto medical treatment is absolute: ‘This right of choice is not limited to decisions which others might regard as sensible. It exists notwithstanding that the reasons for making the choice are rational, irrational, unknown or . .
    ([1992] 4 All ER 649, [1992] 3 WLR 782, [1993] Fam 95)
  • Cited – Sidaway v Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital HL 21-Feb-1985
    The plaintiff alleged negligence in the failure by a surgeon to disclose or explain to her the risks inherent in the operation which he had advised.
    Held: The appeal failed. A mentally competent patient has an absolute right to refuse to . .
    ([1985] 1 All ER 643, [1985] 2 WLR 480, [1985] AC 871, , [1985] UKHL 1)
  • Cited – Regina v Stone and Dobinson CACD 1977
    The male defendant, Stone, and his mentally disabled son lived in Stone’s house with the female defendant, Dobinson. Stone’s sister came to live as a lodger. She neglected herself to such an extent that she became helplessly infirm. Fanny refused to . .
    ([1977] 2 All ER 341, [1977] 2 WLR 169, [1977] 1 QB 354)
  • Cited – Regina v Cox 18-Sep-1992
    Whether the questioning of a suspect in a police station amounted to an interview was a question of fact dependant upon all the circumstances, including the rest, arrival at the police station, caution, the notification of rights, and the nature of . .
    ((Unreported), 18 September 1992, Times 02-Dec-92, [1992] CLY 886)
  • Cited – In re Quinlan 1976
    Protecting the privacy rights of incompetent dying patients. . .
    ((1976) 355 A2d 647)
  • Cited – Nancy B v Hotel-Dieu de Quebec 1992
    An individual of full capacity is not obliged to give consent to medical treatment, nor is a medical practitioner or other service provider under any obligation to provide such treatment without consent, even if the failure to treat will result in . .
    ((1992) 86 DLR (4th) 385, [1992] RJQ 361)
  • Cited – Malette v Shulman Jobes, In re 1990
    ‘The right to determine what shall be done with one’s own body is a fundamental right in our society. The concepts inherent in this right are the bedrock upon which the principles of self-determination and individual autonomy are based. Free . .
    ((1990) 67 DLR (4th) 321, (1987) 529 A 2d 434)
  • Cited – In Re B (A Minor) (Wardship: Medical Treatment) CA 1981
    The child was born with Down’s Syndrome and an intestinal blockage. She needed the obstruction to be relieved if she was to survive. If the operation were performed, the child might die within a few months but it was probable that her life . .
    ([1990] 3 All ER 927, [1981] 1 WLR 1424)
  • Cited – In re B (A Minor) (Wardship: Sterilisation) HL 1987
    The House considered a case involving the sterilisation of a girl just under 18, who suffered from mental disability.
    Held: A court exercising wardship jurisdiction, when reaching a decision on an application to authorise an operation for . .
    ([1988] AC 199, [1987] 2 All ER 206, [1987] 2 WLR 1213, Gazette 13-May-87)
  • Cited – In re C (A Minor) (Wardship: Medical Treatment) CA 1989
    . .
    ([1989] 2 All ER 782, [1989] 3 WLR 240, [1990] Fam 26)
  • Cited – In re F (Mental Patient: Sterilisation) HL 4-May-1989
    Where a patient lacks capacity, there is the power to provide him with whatever treatment or care is necessary in his own best interests. Medical treatment can be undertaken in an emergency even if, through a lack of capacity, no consent had been . .
    ([1990] 2 AC 1, [1989] 2 WLR 1025, [1989] 2 All ER 545, CA and HL(E), )
  • Cited – In re J (a Minor) (Wardship: Medical treatment) CA 1-Oct-1990
    J was born at 27 weeks’, weighing only 1.1kg. He suffered very severe and permanent brain damage at the time of his birth, the brain tissue then lost being irreplaceable. He was epileptic and the medical evidence was that he was likely to develop . .
    ((1991) Fam 33, [1990] 3 All ER 930, [1991] 2 WLR 140, Times 03-Oct-90, [1992] 1 FLR)
  • At FD – Airedale NHS Trust v Bland FD 19-Nov-1992
    The patient had suffered catastrophic injuries in 1989, leaving him in a persistent vegetative state (PVS). The doctors sought leave to discontinue life maintaining treatment and medical support. The inevitable result would be his death. The . .
    (, [1993] 2 WLR 316)
  • Cited – Bolam v Friern Hospital Management Committee QBD 1957
    Negligence was alleged against a doctor.
    Held: McNair J directed the jury: ‘Where some special skill is exercised, the test for negligence is not the test of the man on the Clapham omnibus, because he has not got this special skill. The test . .
    ([1957] 1 WLR 582, [1957] 2 All ER 118)

This case is cited by:

  • At CA – Airedale NHS Trust v Bland HL 4-Feb-1993
    Procedures on Withdrawal of Life Support Treatment
    The patient had been severely injured in the Hillsborough disaster, and had come to be in a persistent vegetative state (PVS). The doctors sought permission to withdraw medical treatment. The Official Solicitor appealed against an order of the Court . .
    (, [1993] AC 789, [1993] 2 WLR 316, , [1993] UKHL 17, , [1992] UKHL 5)
  • Cited – Portsmouth NHS Trust v Wyatt and others FD 7-Oct-2004
    Charlotte Wyatt was born prematurely, and depended for day to day her life on medical support. Her doctors asked to be permitted not to resuscitate her again if she needed it. Her parents asked that she be given whatever chance was available for her . .
    (, [2004] EWHC 2247 (Fam), [2005] 1 FLR 21, [2004] Fam Law 866, (2005) 84 BMLR 206)
  • Cited – Nicklinson and Another, Regina (on The Application of) SC 25-Jun-2014
    The court was asked: ‘whether the present state of the law of England and Wales relating to assisting suicide infringes the European Convention on Human Rights, and whether the code published by the Director of Public Prosecutions relating to . .
    (36 BHRC 465, [2015] 1 AC 657, 139 BMLR 1, [2014] WLR(D) 298, [2014] 3 FCR 1, [2014] HRLR 17, [2014] 3 WLR 200, [2014] 3 All ER 843, (2014) 139 BMLR 1, , UKSC 2013/0235, , , , , [2014] UKSC 38, [2014] 3 WLR 200)

These lists may be incomplete.
Last Update: 26 November 2020; Ref: scu.174706