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This book explores the use of tube feeding as a means of life support. Since food and water given via a tube is deemed to be “medical treatment” doctors are permitted to withhold or withdraw tube feeding under some circumstances, with the result that the patient will die of dehydration or starvation. This dark side of medical ethics is explored through case reports, press reports, and analysis of professional guidelines. American author Wesley J Smith paints a worrying picture of futile care theory as practised in the USA, yet we in the UK are in danger of following suit.
In 1999 the British Medical Association (BMA) issued guidelines on “Withholding and Withdrawing Life-prolonging Medical Treatment” that caused widespread concern. The BMA strongly refuted the suggestion that non- provision of tube feeding is a form of euthanasia, but some people took a different view. Attempts to protect patients by Act of Parliament failed. Guidance published by the General Medical Council in 2002 was subjected to critical appraisal in the High Court in 2004/5. The interface between medical ethics and the law is fraught with difficulty.
Medical practice has become polluted by politics as governments seek to con- tain the cost of health care. Faced with an ageing population and limited re- sources the weakest go to the wall. The lives of children with learning disabilities, mentally incapacitated adults and the frail elderly are now at risk.
Society is deeply divided about how to tackle these difficult problems. At one extreme are those who campaign for active euthanasia- at the other are those who hold all human life to be sacred. It remains to be seen how events will evolve in the years ahead. This book should be of interest to all who are likely to be involved in difficult “end-of-life decisions” in years to come.