French doctors have been told by the European court of human rights that they can switch off the life-support system of a man who has been in a coma for seven years.
The ruling by the grand chamber of the Strasbourg court will form a precedent across the continent for other cases in which families and medical staff are in dispute over how long patients in a vegetative state should be treated.
Vincent Lambert, 39, suffered serious head injuries in September 2008. He was left a tetraplegic and in a condition of complete dependence. He receives artificial nutrition and hydration administered through a gastric tube.
His relatives and doctors were divided over how he should be treated. His wife, Rachel, agreed with doctors that they should put an end to the intravenous food and water that was keeping him alive.
The court heard that Lambert had confided in his wife and one of his brothers a desire not to be kept alive in a highly dependent state, but had left no formal statement. He did not share the views of his deeply religious Catholic parents who support the idea that doctors should respect the “sanctity of life”, the court heard.
French law does not authorise either euthanasia or assisted suicide but permits doctors to discontinue treatment only if continuing it would demonstrate “unreasonable obstinacy”.
Lambert’s parents argued that withdrawing nutrition and hydration would be in breach article 2 of the European convention on human rights, which guarantees the right to life. Depriving him of nutrition and hydration would also constitute ill-treatment amounting to torture within the meaning of article 3 of the convention, they maintained.
By acknowledging that the decision was primarily for the domestic authorities, the Strasbourg court reinforced the principle that member states have a wide “margin of appreciation” as to how to decide such complex issues according to their own national laws and traditions.
The ECHR judgment said that in “39 of the 47 Council of Europe member states, no consensus exists in practice in favour of authorising the withdrawal of treatment designed only to prolong life artificially”. In the majority of countries, treatment may be withdrawn subject to certain conditions; in other states legislation prohibits withdrawal or is silent on the subject.
The Strasbourg court concluded that France’s domestic courts had “complied with their positive obligations flowing from article 2 of the convention” in allowing doctors to turn off his life-support systems.
