Article Text

Download PDFPDF

Court applications for withdrawal of artificial nutrition and hydration from patients in a permanent vegetative state: family experiences
  1. Celia Kitzinger1,
  2. Jenny Kitzinger2
  1. 1Department of Sociology, University of York, York, UK
  2. 2School of Journalism, Culture & Media Studies, Cardiff University, Cardiff, UK
  1. Correspondence to Professor Jenny Kitzinger, School of Journalism, Culture & Media Studies, Cardiff University, Cardiff CF10 3NB, UK; kitzingerj{at}


Withdrawal of artificially delivered nutrition and hydration (ANH) from patients in a permanent vegetative state (PVS) requires judicial approval in England and Wales, even when families and healthcare professionals agree that withdrawal is in the patient's best interests. Part of the rationale underpinning the original recommendation for such court approval was the reassurance of patients’ families, but there has been no research as to whether or not family members are reassured by the requirement for court proceedings or how they experience the process. The research reported here draws on in-depth narrative interviews with 10 family members (from five different families) of PVS patients who have been the subject of court proceedings for ANH-withdrawal. We analyse the empirical evidence to understand how family members perceive and experience the process of applying to the courts for ANH-withdrawal and consider the ethical and practice implications of our findings. Our analysis of family experience supports arguments grounded in economic and legal analysis that court approval should no longer be required. We conclude with some suggestions for how we might develop other more efficient, just and humane mechanisms for reviewing best interests decisions about ANH-withdrawal from these patients.

  • Family
  • Right to Refuse Treatment
  • Public Law
  • Prolongation of Life and Euthanasia
  • Legal Aspects

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Other content recommended for you