The General Medical Council (GMC) today won its appeal against a court ruling that gave a terminally ill patient the right to life-prolonging treatment.
Leslie Burke, 45, who has a degenerative brain condition, won a high court ruling last year to stop doctors withdrawing food and drink during the final stages of his illness.
But a panel of three judges headed by the master of the rolls, Lord Phillips, today overturned the decision, which was hailed as a landmark for terminally ill patients.
Under today's court of appeal ruling, doctors will be required to provide life-prolonging treatment, such as water and artificial feeding, if a mentally competent terminally ill patient asks for it. But once a patient loses the ability to express their wishes or lacks mental capacity, their doctor will be able to withdraw such treatment.
The GMC, which regulates the medical profession, said the ruling endorsed its guidance on end of life treatment. The council's president, Professor Sir Graeme Catto, said he hoped Mr Burke was reassured he will receive the treatment he needs, including artificial nutrition and hydration.
Sir Graeme added that the ruling required doctors and patients to work in partnership to "resolve end of life issues". He said: "Our guidance makes it clear that patients should never be discriminated against on the grounds of disability. And we have always said that causing patients to die from starvation and dehydration is absolutely unacceptable practice and unlawful."
A GMC spokeswoman said the ruling did not mean that doctors "will whip out a patient's feeding tubes as soon as they become unable to express their wishes". She predicted that life-prolonging treatment would only be withheld or withdrawn if it caused the patient unnecessary pain and suffering.
She said: "We're talking about whether in the final hours and minutes before you die should doctors have to give you artificial nutrition and hydration. Patients should be reassured that doctors will always act in patients' best interests even once they become unable to express themselves, unless it becomes too burdensome to continue treatment."
But Mr Burke, who has cerebellar ataxia, fears the ruling could mean doctors would let him die of starvation and dehydration while he was totally aware of what was happening. With the support of disability rights campaigners, he is seeking leave to appeal to the House of Lords
Mr Burke, of Newton Estate, Lancaster, said after the judgment: "Obviously I am disappointed that I have not got all that I wished for. I have every wish to take it to the House of Lords even though for me personally I should be OK."
The Disability Rights Commission (DRC) warned that doctors' views on what is in their patients' "best interests" once they lack capacity could be based on discriminatory or negative stereotypical assumptions about disabled people's quality of life.
Bert Massie, the DRC chairman, said: "This ruling means that doctors will have to listen to whether you do, or do not want, life-prolonging treatment if you can make your choices clear. However, that safeguard, for the most fundamental of choices, has not been upheld for the most vulnerable people of all - those who cannot express their wishes.
"Many disabled people fear that some doctors make negative, stereotypical assumptions about their quality of life. This ruling will not allay many of their fears. If you become incompetent someone else can still decide what is burdensome and what is in your best interests."
