The UK Supreme Court [official website] ruled [judgment, PDF] Monday that in cases where a patient is in a permanent vegetative state [NHS backgrounder], the patient may be taken off life support, including feeding tubes, without court approval if both the relatives and the doctors are in agreement. The UK Court of Protection will still issue a ruling in cases where the relatives and doctors disagree.

The case involved a man identified as Mr. Y., who entered a vegetative state over a year ago after suffering cardiac arrest. Two physicians said there was little chance of him regaining consciousness. His family agreed to take him off life support, specifically withdrawing a feeding tube, believing that is what Mr. Y. would have preferred. National Health Services [official website] asked the Supreme Court to drop the court approval requirement. An Official Solicitor [government website] argued in favor of the requirement remaining because the solicitor claimed that the court requirement helps to safeguard the rights of vulnerable patients.

While a doctor could previously withdraw certain forms of life support without court approval, approval was necessary [BBC report] for the withdrawing of a feeding tube.

The majority wrote, “It is lawful to give treatment only if it is in the patient’s best interests. Accordingly, if the treatment would not be in the patient’s best interests, then it would be unlawful to give it, and therefore lawful, and not a breach of any duty to the patient, to withhold or withdraw it.”

The court found that there was no domestic or international law precedent that required court approval for the withdrawal of feeding tubes if both physicians and families felt it was in the patient’s best interest.