In the case of an insensate patient like Bland who lacked the capacity to validly consent
or refuse medical treatment, the lawfulness of such medical treatment depended upon
whether it was in the best interests of the patient (per Sir Thomas Bingham in Airedale
NHS Trust v Bland (‘‘Airedale NHS Trust v. Bland’’ 1993 at p. 843). The court further held
that doctors were not under an unqualified duty to prolong life at all costs; accordingly, the
duty to provide medical care ‘‘ceases when such treatment can serve no humane purpose’’
(per Lord Hoffman in Airedale NHS Trust v Bland (‘‘Airedale NHS Trust v. Bland’’ 1993
at p. 856). In Bland’s case, the futility of the treatment in providing him any quality of life
ethically justified its termination (per Lord Goff in Airedale NHS Trust v Bland (‘‘Airedale
NHS Trust v. Bland’’ 1993 at p. 870).
A patient’s right to autonomy was reiterated in Ms B v An NHS Hospital Trust (‘‘Ms B
v An NHS Hospital Trust’’ 2002). Here, the case involved a patient who was mentally
competent and had repeatedly yet unsuccessfully requested for the withdrawal of medical
therapy to which she was subjected. Ms B suffered a spinal cavernoma, which necessitated
neurological surgery to remove it. During the course of her hospitalisation and treatment,
she executed a living will stating that if at any point of time, she was incapable of giving
instructions, she wanted treatment to be withdrawn if she was suffering from a life-
threatening condition, permanent mental impairment or permanent unconsciousness.
Unfortunately, as a result of the surgery, Mrs B became completely paralysed from the
neck down and was treated with a ventilator to ease her respiratory problems. She even-
tually regained some movement in her head and was able to speak, pursuant to which she
requested to her clinicians on several occasions to have the ventilator removed. The
clinicians were not prepared to do so as they considered it to not be in her best interests, i.e.
it would inevitably lead to her death. In allowing Mrs B’s claim for a declaration that the
hospital had been treating her unlawfully, the court upheld the principle of self-determi-
nation, referring to the judgements delivered by the bench in Airedale NHS Trust v Bland
