Tony Bland

Anthony David Bland (21 September 1970 – 3 March 1993) was a supporter of Liverpool injured in the Hillsborough disaster.

He suffered severe Brain Damage that left him in a persistent vegetative state as a Consequence of which the hospital, with the support of his parents, applied for a court order allowing him to "die with dignity".

As a result, he became the first patient in English legal history to be allowed to die by the courts through the withdrawal of life-prolonging treatment including food and water for the injuries.

In R v Arthur a baby was born in 1981 with uncomplicated Down Syndrome and was rejected by the parents.

Leonard Arthur, a paediatrician, wrote in his notes that the "Parents do not wish it to survive. Nursing care only."

The baby died 69 hours later.

During the trial, the defence provided evidence that the child was not physically healthy, resulting in a reduced charge of attempted murder, for which Arthur was acquitted.

This demonstrated that a doctor who deliberately withdrew life-prolonging treatment under any circumstances, and where the patient subsequently died, could be charged with murder.

There was a subtle exception.

If a patient suffered complications but the doctors felt that it would serve no purpose to apply additional treatments, such as antibiotics to fight infection, as might happen in a case of PVS, and the patient subsequently died as a result of the complication, then they were not liable under the criminal law.

Theoretically, however, they could still find themselves being sued for negligence by the family of the deceased.

Bland was an 18-year-old Liverpool supporter who travelled with two friends to Sheffield Wednesday's Hillsborough football ground for an FA Cup semi-final between Liverpool and Nottingham Forest on 15 April 1989.

During the game, a crush behind the Liverpool goal ensued due to the police losing control of the situation outside the ground.

A crush had formed at the outer gates, and the Liverpool fans were eventually let in through a side gate by order of Chief Superintendent Duckenfield.

However, he failed to close the tunnel access first and thousands more Liverpool fans were sent down this tunnel into pens 3 and 4 which were already overcrowded due to the failure of police officers and club stewards to direct the fans to the appropriate areas.

In August 1989, four months after Bland was injured, Howe contacted Popper, the Sheffield coroner, who was both legally and medically qualified.

He never regained consciousness and a legal ruling in November 1992 allowed doctors to withdraw his treatment at the request of his family, as there had been no sign of improvement in his condition and the doctors treating him advised that there was no reasonable possibility that he would ever emerge from his persistent vegetative state, and was unlikely to survive more than five years.

Bland suffered serious injuries in the crush at the Leppings Lane terrace.

He suffered crushed ribs and two punctured lungs, causing an interruption in the supply of oxygen to his brain.

As a result, he sustained catastrophic and irreversible damage to the higher centres of the brain, which had left him in a persistent vegetative state (PVS).

He was transferred to the care of J. G. Howe, a consultant geriatrician and neurologist at the Airedale General Hospital near his home in Keighley.

He had some experience in treating those with PVS.

Several attempts were made by Howe and his team, along with Bland's father, sister and mother, to try to elicit some response from him and for some signs of interaction.

However, all attempts failed.

He showed no sign of being aware of anything that took place around him.

EEG and CT scans revealed that whilst the brain stem remained intact, there was no cortical activity.

Indeed, scans subsequently shown to the court showed more space than substance in the relevant part of his brain.

His body was being kept alive by artificial nutrition, hydration and constant care.

The medical professionals treating him stated that there was no reasonable possibility that he would ever emerge from his vegetative state.

Prior to Bland, English case law on the non-treatment of patients was restricted to newborn babies.

There have been several recorded cases of disabled neonates being "allowed to die".

A leading case was that of Re B (a minor).

That case involved a baby with Down syndrome complicated by intestinal obstruction which, if left untreated without surgery, would be fatal.

The parents felt that it would be in the child's best interests if she were left to die.

This was a decision upheld by Lord Justice Dunn at first instance, who lauded the parents' decision as being "an entirely reasonable one".

The matter reached the Court of Appeal who overturned the decision.

Any such decision had to be made in the best interests of the child and that the prognosis was that the child would have a reasonable quality of life.

However, in other cases, for example Re C (a minor) (wardship: medical treatment) and Re J (a minor) (wardship: medical treatment), this test has been used to determine that doctors can choose not to treat or provide life prolonging treatment.

Although Bland survived the initial crush, he had suffered severe Brain Damage and eventually became the disaster's 96th victim on 3 March 1993, aged 22, after being in a coma for nearly four years.

This resulted in the death of 94 people on that day, and a 95th victim in hospital a few days later.