HC Deb 12 July 2002 vol 388 cc1273-4W
Mr. Drew

To ask the Secretary of State for Health (1) what his policy is on the use of sedation, with specific reference to withholding food and fluid from a patient; [67215]

(2) what his policy is on withholding food and fluid from patients and the notice to be taken of relatives' wishes; [67214]

(3) what advice his Department offers on the use of drugs that suppress the symptoms of terminal dehydration. [67216]

Mr. Lammy

I am advised that food and fluids should always be offered to patients who are capable of swallowing them. For terminally ill patients in the final days of life the objective is to control distressing and painful symptoms. Achieving such control may result in sedation. Many patients stop drinking and eating during the final days and it will be for clinical judgment to decide what is the appropriate treatment. Where nutrition and hydration have to be provided by artificial means, their possible withdrawal is in all cases a matter of clinical judgment which is undertaken in accordance with professional advice in accordance with a responsible body of medical opinion and the general law.

An adult patient who is capable of making his or her own treatment decision is entitled to do so and can refuse artificial hydration and nutrition just as he can any other form of treatment. In the absence of a valid advance refusal of treatment, doctors are required to act in the best interests of a adult patient who is unable to make his or her own treatment decisions. Sometimes this will mean that medical treatment (which includes artificial hydration and nutrition) which is no longer beneficial to the patient should be withdrawn. In these circumstances, suitable medical or other care should be provided to ensure that the comfort and dignity of the patient are maintained. In line with good practice, decisions to withdraw medical treatment should be made only after discussions with the healthcare team and those close to the patient.

Guidance in relation to palliative care (Changing Gear—Guidelines for Managing the last days of life in adults) was issued by the Department of Health in 1998, and advice on withdrawing and withholding treatment was included in the Reference Guide to Consent for Examination and Treatment, published in March 2001. Further guidance is also available from the British Medical Association.