A patients best interest? Really?

In a report headlined "Court ruling not needed to withdraw care, judge says", the BBC reports in its analysis of a court ruling with regard to patients in a permanent vegetative state that:

Today's ruling makes clear that as things stand, courts need not be involved in these sorts of cases, so long as doctors and families are in agreement, and the removal of food and water are in the best interests of the patient.

They quote a spokesperson of Compassion in Dying (a pro-euthanasia campaign group) as saying:

"When all parties - family, the hospital and treating doctors - are agreed on what someone would have wanted for their care, it seems absurd to require a costly court process to confirm this." 

The good of human life, in its ethical sense, means that it can never be supportive of that ethical good to remove nutrition and hydration from a human person. They are so fundamental to the good of life that their removal on the grounds of "best interest" in reality constitutes a denial of that good.

[From an ethical point of view, the removal of nutrition and hydration if provided by a clinical means such as a nasogastric tube may only be justifiable when a patients condition reaches the point where their organs are no longer able to metabolise that food and water. Its provision is then futile in the strict sense, and there is no ethical judgement in terms of "best interest", there instead being a quite different recognition of futility. I suspect that such a situation might only be reached in the last minutes or hour of life; and the situations being envisaged by this court judgement are not of this type at all.]

How family, hospital and treating doctors are entitled, or even able, to agree on what a non-communicative patient would have wanted for their care at the particular moment is also a mystery. That a spokesperson for a euthanasia campaign group should be quoted in this way is worrying for its indication of the potential pressure (from decision making by others) on patients to agree to steps taken to end their lives should euthanasia be legalised at some point in the future.

This ruling is likely to be appealed - with the potential that, if it is upheld at appeal, there will be no further redress.