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

Court decision

The principle of autonomy requires that respect must be given to the wishes of a patient and, in the Bland case, the judge, stated that "the principle of sanctity of human life must yield to the principle of self determination." On the other hand, the sanctity of life argument rejects the theory that one human life is more valuable than another. Therefore, all human life has an equal value. Countering this is the argument that sanctity of life is not absolute, i.e. there are circumstances when it is lawful to take another's life, for example self-defence.

The Bland case concerned the legality of withdrawing artificial hydration from a permanently unconscious patient in a condition known as 'persistent vegetative state' (PVS). For some, the case raised the question of the legality of euthanasia. Tony Bland's nasogastric tube was removed and feeding and hydration stopped and this was deemed to be an omission rather than an act, as the tube itself, without the food being supplied through it, does nothing for the patient. The removal of the tube by itself does not cause the death since by itself it does not sustain life.

In the Bland case, it was felt that removal of the naso-gastric tube through which he was fed would not constitute the actus reus necessary for murder, as that positive act would not be the cause of his death. "The omission is not a breach of duty by the doctor, because he is not obliged to continue in a hopeless case." (Professor Glanville Williams).

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