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Suing to Stay on Life Support

A court case that speaks to choice in healthcare

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A man named Leslie Burke, who's a patient in England, has thrown a legal challenge to Britain's universal tax-supported healthcare system. The outcome could serve as a lesson for any nation with a strong or growing government role in personal healthcare.

Mr. Burke is mentally competent, but because his doctors say a debilitating condition might result in him needing food and water through a tube, he sued the National Health Service (NHS) to guarantee that it not withhold such care should he need it. He did not want to be dehydrated against his wishes. He won the first round.

Burke challenges what is known in medical circles as "futile care protocols." These are practiced in Britain when hospital ethics committees authorize doctors to unilaterally cease treatment for "hopeless" cases. It's a policy that led the NHS and a doctors' association to appeal the decision. The case is now before the intermediate Court of Appeal.

This legal contest evokes the recent case of the Florida courts allowing the husband of Terri Schiavo to remove her feeding tube. Burke, however, asks that his directive to sustain his life be honored, despite any future opinion by doctors about his quality of life or prospects for living, and despite the government's interest in containing healthcare costs.

Compromising doctors' expertise

No one disputes that the British system has so far provided Burke with excellent care. But rather than trust the "hand that holds the scalpel," he's essentially sought a lawyer at his bedside. The General Medical Council, representing doctors, says the lower-court decision compromises the practice of allowing professional medical judgment as the best arbiter. If upheld, the doctors and government claim, the decision could lead to any number of demands by patients for "critical" treatment, forcing a general reduction in care if taxpayers aren't willing to bear the increased costs. As it is, many patients now face delays or reduced care due to mismanagement or current rationing of care.

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