New BMA guidelines on withdrawing food and fluids "euthanasia by stealth"
17 December 2018
Brain damaged patients can be dehydrated and starved to death under the new guidelines.
A worrying development.
Care not Killing has described new guidelines released by the British Medical Association last week as "euthanasia by stealth".
The guidance, published jointly with the Royal College of Physicians, and endorsed by the General Medical Council, relates to the withdrawal of clinically assisted nutrition and hydration (CAHN) from brain-damaged patients.
Safeguard of courts removed
It follows a Supreme Court judgement in June that laid down that if families and doctors are in agreement, patients diagnosed as being in a permanent vegetative state (PVS) or minimally conscious state (MCS) can have food and fluid withdrawn without their case being taken to the Court of Protection. . It means that clinical staff can now effectively starve and dehydrate people to death without having to go to through the courts.
This will affect up to 24,000 patients with PVS and MCS, but in a worrying development the BMA have extended the guidance to include those suffering with severe strokes and dementia.
Death by dehydration
Care not Killing explains:
People with PVS (awake but not aware) and MCS (awake but only intermittently or partially aware) can breathe without ventilators but need to have food and fluids by tube (clinically assisted nutrition and hydration or CANH).
These patients are not imminently dying and with good care can live for many years. Some may even regain awareness. But if CANH is withdrawn, then they will die from dehydration and starvation within two or three weeks.
Dr Peter Saunders, outgoing director of the Care Not Killing campaign, said: It’s "euthanasia by stealth whereby patients can be dehydrated and sedated to death within one or two weeks when they would have lived for years or decades.
"If people who are creating what’s perceived as an economic or social burden upon anyone can have their lives ended, where do you stop with that?" he asks. "Once you allow for this scenario where people can be dehydrated to death without recourse to the courts, you’re putting a dangerous temptation in front of healthcare professionals."
CNK is urging the BMA to review the guidance.
Putting the disabled at risk
Dr Anthony McCarthy of SPUC commented:
"Worryingly, these guidelines admonish doctors not to let their own positive views on the value of life have any effect in determining what is in their patients' best interests. Patients who have made even informal comments to relatives about not wanting to live and 'be a burden' in some future event are now at risk of having their lives deliberately ended by the withdrawal of basic care. A patient who may not be suffering in any way, but who may be simply disabled and unable to communicate, can have his life deliberately ended on the assumption that he would not have wanted his family to suffer. Life with a disability is increasingly treated not as having an intrinsic value deserving respect, but as something to cherish only if the patient currently sees it as valuable or previously believed it would be valuable."
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