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Famous cases: Airedale NHS trust vs Tony Bland

Famous cases: Airedale NHS trust vs Tony BlandHow a series of tragic events led to a debate on euthanasia. Is it acceptable to stop medical treatment of someone who is severely brain damaged?

The tragedy

On the 15th of April 1989 Liverpool was playing Nottingham Forest for an FA Cup semi-final at Sheffield Wednesday's Hillsborough football ground. Traffic delays had led to many Liverpool fans arriving late and in the moments prior to kick off there were several thousand fans outside the turnstiles. As a bottleneck developed outside the ground, police, fearing a crush, opened a set of gates leading in to a narrow tunnel at the rear of the terrace. Fans streamed down the tunnel into the already crowded central section of the terrace. At the front of the terrace fans were pushed and crushed against steel fencing installed to prevent hooliganism. 96 people died as a result of the crush at Hillsborough with 766 injured.

Tony’s case – a Persistent Vegetative State

Tony Bland, an 18 year old Liverpool supporter, suffered crushed ribs and two punctured lungs. This interrupted the supply of oxygen to his brain which caused catastrophic and irreversible damage, and left him in a Persistent Vegetative State. He could not see, hear or feel anything.

However the brain stem, which controls the reflexive functions of the body like heartbeat, breathing and digestion, continued to operate. In the eyes of the medical world and of the law a person is not clinically dead so long as the brain stem is still functioning. In order to keep Tony Bland alive in his present condition, he had to be fed with a tube. All medical opinion agreed that Tony Bland would never recover from his present condition, but that he would continue to live for many years as long as he was provided with medical treatment.

The doctors in charge of Tony Bland formed the view, which was supported by his parents, that no useful purpose was to be served by continuing that medical care. They decided that it was appropriate to stop the artificial feeding and other measures aimed at prolonging his existence. In short – there was no benefit to Tony Bland in keeping him alive. Since, however, there were doubts as to whether this might constitute a criminal offence, the Airedale NHS Trust, who were responsible for Bland, asked the High Courts of Justice for advice.

The ruling

The judges debated the moral and ethical issues raised by the case but in the end they agreed that given the circumstances: “ it is perfectly reasonable for the responsible doctors to conclude that there is no affirmative benefit to Anthony Bland in continuing the invasive medical procedures necessary to sustain his life. Having so concluded, they are neither entitled nor under a duty to continue such medical care. Therefore they will not be guilty of murder if they discontinue such care.” Treatment was stopped and Tony Bland died on March 3rd 1993.

The Hillsborough disaster and the following enquiry resulted in the conversion of many football stadiums to all-seater and the removal of barriers at the front of stands.