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Withdrawing life-sustaining treatment: a stock-take of the legal and ethical position
  1. Alexander Charles Edward Ruck Keene1,2,
  2. Annabel Lee2
  1. 1 King’s College London, London, UK
  2. 2 39 Essex Chambers, London, UK
  1. Correspondence to Alexander Charles Edward Ruck Keene, King’s College London, London WC2R 2LS, UK; Alex.ruckkeene{at}


This article, prompted by an extended essay published in the Journal of Medical Ethics by Charles Foster, and the current controversy surrounding the case of Vincent Lambert, analyses the legal and ethical arguments in relation to the withdrawal of life-sustaining treatment from patients with prolonged disorders of consciousness. The article analyses the legal framework through the prism of domestic law, case-law of the European Court of Human Rights and the Convention on the Rights of Persons with Disabilities, and examines the challenge to the ethical consensus made by Foster. It concludes that the right approach remains a version of the approach that has prevailed for the last 25 years since the decision in Airedale NHS Trust v Bland[1993] AC 789, refined to reflect that that there is now, and rightly, a much more limited place for judgments made about the ‘burden’ of treatment or the quality of life enjoyed by the person made on the basis of assumptions about that person as a category as opposed to investigation of that person as an individual human being.

  • clinical ethics
  • decision-making
  • disabilities
  • end-of-life
  • law

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  • Contributors ACERK led on the drafting of the article and AL reviewed and contributed research assistance.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests ACERK was one of the legal advisers to the working group that produced the BMA/RCP Guidance considered in the article. ACERK acted for the Faculty of Intensive Care Medicine/Intensive Society in the case of Aintree University Hospitals NHS Foundation Trust v James [2013] UKSC 67; ACERK and AL both acted for the Faculty of Intensive Care Medicine/Intensive Society in the case of an NHS Trust v Y [2018] UKSC 46.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.

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