A legal ruling that terminally-ill people should ultimately decide whether they receive life-prolonging treatment could put doctors in "an impossibly difficult position", the court of appeal heard today.
The General Medical Council (GMC) said the high court judgment, hailed as a victory for patients' rights, could mean doctors being obliged to provide treatments that were not in their patients' best interests or even harmful.
In his high court judgment last July, Mr Justice Munby said if a patient was competent, or had made an advance request for treatment, doctors have a duty to provide artificial nutrition or hydration (ANH) to prolong their life.
But Philip Havers, QC, representing the GMC, today told three appeal judges - headed by the Master of the Rolls, Lord Phillips - that by law a patient did not have a right to require the provision of any particular form of treatment.
He said the judgment was not in the best interests of patients because doctors would have to provide treatment which they knew to be futile or even harmful.
Mr Havers said this "puts the doctor in an impossibly difficult position, for a doctor should never be required to provide a particular form of treatment to a patient which he does not consider to be clinically appropriate".
The QC added that requiring doctors to do so would undermine their relationship with patients. "Doctors are under a professional duty not to provide such treatments to patients," he said.
Mr Havers said the main purpose of the GMC was to "protect, promote and maintain" the health of the public, including those who need life-prolonging treatment.
To further this end, the council had issued guidance to doctors - but Mr Justice Munby's ruling, which extends "patient autonomy", would fundamentally alter the nature of doctor-patient relationships.
Last July's ruling came after Leslie Burke, who has a degenerative brain condition, took the GMC to court because he feared his wish to go on living until he dies naturally could be overridden under its guidelines.
Mr Justice Munby said that although the bulk of the guidelines were in place to reassure patients and relatives, he took issue with them "in a limited number of respects" and ruled parts unlawful.
Lawyers representing Mr Burke, of Lancaster, claimed the judgment represented a shift in the balance of power away from the doctor to the patient, and from the medical profession to the courts.
Mr Burke, who suffers from cerebellar ataxia, had feared reaching the point where, unable to communicate, he would be denied food and water and would take two to three weeks to die of starvation or thirst. But he won the right to stop doctors withdrawing treatment when his illness reaches its final stages.
Mr Burke sat in the appeal court today as Mr Havers outlined the GMC case for overturning the high court ruling.
