The right-to-die debate is one of the most emotive topics there is. Health Reporter Emma Brady looks at the issue...

A terminally ill patient?s moves to take on the Government over his right to basic care could provide a landmark decision in the right-to-life debate.

Leslie Burke, a 45-year-old postman from Lancaster, suffers from cerebral ataxia ? a degenerative brain condition that will progressively disable him.

Last July, he won the right to stop doctors withdrawing artificial nutrition or hydration (ANH) treatment until he dies naturally.

Health Secretary Patricia Hewitt has now intervened in a General Medical Council challenge to the High Court ruling, hailed at the time as a breakthrough for terminally ill patients.

Department of Health officials claimed if a right to ANH was established, patients would demand other lifeprolonging treatments.

Last month Philip Sales, representing Ms Hewitt, told a panel of appeal judges led by Master of the Rolls Lord Phillips: ?A general right, as identified by the judge in the High Court, for an individual patient to require lifeprolonging medical treatment has very serious implications for the functioning of the NHS.?

But Mr Burke?s case is not the first, nor will it be the last, to raise the emotive issue of patients? rights and who, ultimately, has the right to end a person?s life.

Terri Schiavo?s death in March saw America?s longest right-to-life case come to an end when she died in a Florida hospice after 13 days without food or water.

The 41-year-old became disabled and left in a vegetative state in 1990 after she collapsed at her home in Clearmount, Florida.

A bitter battle ensued between Mrs Schiavo?s husband Michael, who insisted his wife would want to die, and her parents Bob and Mary Schindler who wanted her to live.

Although more than 60 court actions and appeals were thrown out by the US Supreme Court over 12 years, Terri?s parents were forced to watch her die.

Both cases illustrate the need for clear guidance to be set down, and the Appeal Court?s decision in Mr Burke?s case could either further erode patients? rights or bolster them.

Dr Elizabeth Draper, senior lecturer in biomedical ethics at Birmingham University, agrees more clarity is needed in this ?ethically grey area?.

She said: ?In cases such as Leslie Burke?s, where the patient clearly has the ability to make decisions and can articulate them, you can see his point of view ? t?s his life and if this is what he wants then that should be respected.

?However, it?s always difficult for a doctor because they have to do what they think is in the patient?s best interest, which is more than likely the best possible clinical outcome.

?The dilemma comes when a patient asks a doctor to do something that contradicts that fundamental belief.

?Overall, it is an ethically grey area, for example is ?peg feeding? ? feeding a patient liquidised food through a tube directly into their stomach ? a basic right that can?t be withheld or a treatment which can be withdrawn.?

While the Government has declared that patients should not be guaranteed the right to life-prolonging treatment in all situations, introducing effective legislation could prove difficult.

Dr Draper said: ?I don?t think it?s possible to introduce legislation about withdrawing or withholding treatment, because the case law is so strong.

?But when judges have made a decision on Burke?s appeal case ? even if it goes to the Lords ? we will have an important precedent to observe then.?

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