A High Court judge's ruling that a brain-damaged, minimally conscious woman should not be allowed to die was hailed today as a landmark decision which clarified the law relating to the care of the severely disabled.
Mr Justice Baker concluded that life-supporting treatment should not be withdrawn from the 52-year-old former hairdresser and said there was dignity in the life of a disabled person who was "well cared for and kept comfortable".
The judge said an English court had never before been asked to consider whether life-supporting treatment should be withdrawn from a patient who was not in a persistent vegetative state but was minimally conscious.
His ruling came nearly two decades after leading judges ruled that Liverpool soccer fan Tony Bland - left in a permanent vegetative state after being crushed at the 1989 Hillsborough stadium disaster - could be allowed to die.
Mr Justice Baker said the woman, who cannot be identified but lives at a care home in the North of England, had "some positive experiences" which could be "extended".
"The factor which does carry substantial weight, in my judgment, is the preservation of life," said the judge, who had heard legal argument during a Court of Protection hearing in London in July.
"Anyone would wish the end of life to be as dignified as possible. In my judgment, however, there is dignity in the life of a disabled person who is being well cared for and being kept as comfortable and as free from pain as possible, and being provided with the maximum opportunity to extend their enjoyment of life that their disability allows."
Relatives wanted artificial nutrition and hydration withdrawn and said the woman, referred to as M in court, would not want to live "a life dependent on others".
But a lawyer appointed by the High Court to represent the woman opposed the relatives' application, arguing that she was "otherwise clinically stable".
The local health authority responsible for commissioning her care also opposed the relatives' application and said the woman's life was "not without positive elements".
Mr Justice Baker heard that M suffered profound brain damage in 2003 after being diagnosed with viral encephalitis.
She was in a coma for several weeks and had been thought to be in a persistent vegetative state. Doctors later concluded that she was in a minimally conscious state - a state just above a persistent vegetative state.
The court heard evidence from M's sister, B, and partner, S. B broke down as she described M's "awful existence".
Lawyers representing M's family said relatives were "deeply disappointed" and were considering an appeal.
But Yogi Amin, a partner with law firm Irwin Mitchell, which represented relatives, added that the ruling was a "landmark" and the law had been "clarified".
"They brought this application to court in what they perceive to be her best interests. There can be no question that the past eight years have been extremely heart-breaking for them all," he said.
"They love her dearly and want only what is best for her, and it has been desperately difficult for them to make this application to court for treatment to be withdrawn. They believe that M was clear that she would not have wanted to live in the condition that she is in.
"However, the judge has decided in this particular case, after considering all the evidence, that balancing the benefits and disbenefits to M does not fall on the side of withdrawing treatment.
"This is a very important judgment. The law has been clarified and, going forward, in all such cases of patients who are in a minimally conscious state, the High Court does now have the power to decide on whether it is in that patient's best interests for treatment to continue or whether the patient should be allowed to die naturally, with dignity."
He added: "The High Court judge has clarified the law and decided that it is for the court to carry out a balancing exercise and decide if withdrawal of treatment is in the patient's best interests. In this case he has ruled that overall M's current life was not overwhelmingly negative."
Campaign group the ProLife Alliance said the ruling was of "seminal importance".
"A ruling in favour of withdrawal would have created a new precedent for killing patients with a significantly higher level of consciousness than Tony Bland," said a spokeswoman.
"It was a frightening attempt to widen the goalposts, but justice and humanity have prevailed, and an extremely dangerous precedent has been avoided."