The special issue brings together a number of articles centred largely around the issues raised by the 2011 decision of the English Court of Protection in W v M, where the mother of an adult patient applied for the withdrawal of life-sustaining treatment (specifically, artificial nutrition and hydration). This was the first reported legal case concerning withdrawal of artificial nutrition and hydration from a patient in a minimally conscious state who was otherwise stable.
In an open access article, Dr Julian C Sheather, Ethics Department, British Medical Association, explores the case and its repercussions. Dr Sheather explains how, “the judgement makes it clear that the obligation on health professionals falls strongly in favour of preserving life,” and “although the Court sought to limit the judgement as closely as possible to the facts of the case, it is likely to have a significant impact on life-sustaining treatment decisions for people in states of low awareness.”
In another open access article, Dr Sheather explores the question of whether the former wishes of a once-autonomous adult should be respected after the capacity to make decisions to realise those wishes is lost.
For further details see the September 2013 issue of the Journal of Medical Ethics.