The General Medical Council won its appeal today against a court ruling which enabled terminally-ill patients to force doctors to give them life-saving nutrition where there is a disagreement over treatment.

Leslie Burke, 45, who has a degenerative brain condition, won a ruling last year in the High Court to stop doctors withdrawing food and drink.

But today a panel of three judges headed by Master of the Rolls Lord Phillips set aside the decision of Mr Justice Munby, which was hailed as a landmark for terminally-ill patients at the time.

The GMC argued that the original ruling put doctors in "an impossibly difficult position" as it would oblige a doctor to provide treatment that the patient demands, even if the professional is that it would be futile. The GMC believes that a patient does not have the right to demand any particular form of treatment.

Mr Burke, of Mardale Road, Newton Estate, Lancaster, who suffers from cerebellar ataxia, had feared reaching the point where, unable to communicate, he would be denied food and water and would take two to three weeks to die of starvation or thirst.

Lawyers acting for Mr Burke said the appeal court ruling may have been a technical win for the GMC but was a "significant and practical victory" for their client and other patients like him.

His solicitor, Paul Conrathe, said: "Mr Burke brought this case because he wanted to be sure that he would be provided with food and water until he died of natural causes.

"He was concerned that doctors would deny that request.

"The Court of Appeal have confirmed that patients like Mr Burke who want food and water have to be given it.

"Failure to do so would constitute murder. This is a significant matter for him."

Lord Phillips, giving the ruling of the court, said: "Where a patient indicates his or her wish to be kept alive by the provision of artificial nutrition and hydration (ANH), any doctor who deliberately brings that patient’s life to an end by discontinuing the supply of ANH will not merely be in breach of duty but guilty of murder."

Where the Court of Appeal disagreed with Mr Justice Munby was over a situation where a patient’s request for ANH was against a doctor’s judgment that it would cause distress to the patient.

"Ultimately, however, a patient cannot demand that a doctor administer a treatment which the doctor considers is adverse to the patient’s clinical needs.

"This said, we consider that the scenario that we have just described is extremely unlikely to arise in practice."

After the judgment, Mr Burke said: “Obviously I am disappointed that I have not got all that I wished for. I have every wish to take it to the House of Lords even though for me personally I should be OK.” He was refused permission to take the case to the Law Lords but can petition the House for a hearing.

Joyce Robins, co-director of human rights campaign group Patient Concern, which helped argue Mr Burke should have the right to food and water, said the decision was a disappointment and "a huge step backwards"

She said: "Doctors again have extraordinary power over us, making decisions on how and when we die.

"This is a huge step backwards for patients.

"The right to food and water is a right to simple basic sustenance but because they are considered treatment, they can now be taken away.

"We feel the judges are completely out of touch with the feelings of people in Leslie’s position.

"Patients are entirely at the mercy of doctors making the decision over whether they live or die, which is obviously an intensely personal decision.

"This is only round one. We will take this all the way to Strasbourg if we have to."

Professor Sir Graeme Catto, president of the GMC, said: "Patients should be reassured by this judgment, which emphasises the partnership needed to resolve end of life issues.

"Our guidance makes it clear that patients should never be discriminated against on the grounds of disability.

"And we have always said that causing patients to die from starvation and dehydration is absolutely unacceptable practice and unlawful.

"Today the Court has reinforced our position on these points. In the light of the judgment, we shall look at what further steps we can take to explain and promote good practice in this area."

In a footnote to the judgment, Lord Phillips said that people in the "unhappy position" of Mr Burke "are entitled to have confidence that they will be treated properly and in accordance with good practice, and that they will not be ignored or patronised because of their disability".

He said the GMC’s guidance for doctors on whether to withhold or withdraw life-prolonging treatments should be "vigorously promulgated, taught, understood and implemented at every level and in every hospital".

"If the extensive interest generated in this case helps achieve that objective, the proceedings will have served a useful purpose."

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