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Extract of Case Analysis by Isobel Stevenson

"The debate over whether to withdraw Peter’s food supply in the above case arises from the conflicting values of his parents and his doctors. Peter’s perspective is central to evaluating the case; the withdrawal of his feeding tubes violates his right to life. The constraint of Peter’s role is that being in a persistent vegetative state, he is unable to exercise his autonomy and indicate what value he believes should be placed on his life.

As Peter is unable to express his judgement, and we don’t know if he has expressed an opinion prior to this event, his parents take on the role of representing his interests. His parents are required to use their knowledge of Peter’s values to decide his best interests.

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The best possible ethical response to this case is not to end Peter’s life against the will of his parents, nor is it to leave him dependent on a feeding tube indefinitely. Ideally a situation would be created where his parents made the decision to end Peter’s life. I would advise the judge to recommend counselling for his parents, to enable them to address their grief, and come to a place where they are able to let go of Peter’s physical form.

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The ethical response I have given depends on the assumption that Peter’s life is no longer of intrinsic value to him, as claimed by his doctors. If it was known that Peter was aware of pain, then I would form an argument for ending his life regardless of his parents’ consent. If it could be shown that Peter was aware of what was going on around him, but was not in pain, this would again alter my decision. The implications of being aware but unable to respond would need to be considered. The other particular given in the case, which initially seems to differentiate it from a general debate about euthanasia of incompetent patients, is that Peter is receiving palliative care rather than medical treatment. This affects whether his treatment is understood as ordinary or extraordinary, but this distinction doesn’t seem to affect whether the continuation or withdrawal of care is morally obligatory.

The decision I have advised in this case seems to be the best possible ethical response, but it is unknown whether it would be successful in practice. The response assumes that Peter’s parents are adamant that his palliative care continues because they feel connected to their son by his physical presence, and are enabled by the continuation of his life to foster hope. It is possible that his parents object to ending his life for other reasons, such as religious beliefs. If this were the case I still believe a strong attempt to convince Peter’s parents to consent must precede the involuntary ending of Peter’s life if such an action is to be ethically defensible."

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