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Airedale National Health Service Trust v Bland [1993] 1 All ER 821

Tony Bland, aged 17.5 years, went to Hillsborough Football Club on 15 April 1989 to support his team Liverpool in a Cup match. During the disaster that occurred on that day his lungs were crushed and punctured and the supply of oxygen to his brain was interrupted. As a result he suffered severe and irreversible damage to the higher centres of his brain, leaving him in a persistent vegetative state (PVS). The characteristics of PVS are that the brain stem remains alive and functioning while the cortex of the brain loses its function and activity. Thus the PVS patient continues to breathe unaided and his digestion continues to function. But, although his eyes are open, he cannot see. He cannot hear. Although capable of reflex movement, particularly in response to painful stimuli, the patient is incapable of voluntary movement and can feel no pain. He cannot taste, smell, speak or communicate in any way and has no emotions. There is no hope of improvement or recovery.

He is fed by naso-gastric tube and his bowels are evacuated by enema. He is catheterised. At no time before the disaster did Tony Bland give any indication of his wishes should he find himself in such a condition. After careful thought his family agreed that the feeding tube should be removed and felt that this was what Tony Bland would have wanted.

Airedale NHS Trust applied to the High Court to be able to lawfully discontinue all life-sustaining treatment and medical support, including the termination of ventilation, nutrition and hydration by artificial means; and to lawfully discontinue treatment except in enabling him to die peacefully with the greatest dignity and without pain and distress.

Legally, Tony Bland was still alive, even though he was in PVS. The question in this case may be seen as one of not killing the patient, but rather as one of whether the doctor should or should not continue to provide his patient with medical treatment or care which, if continued, will prolong his patient's life. Is treatment, that has the effect of artificially prolonging life, always in the best interests of the patient?

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