"This is a complex and tragic case which demonstrates very clearly that the
situation constituted a true ethical dilemma. There is no room for negotiating
around the issues or for turning them into technical problems; the case makes
it clear that whatever decisions are made, there will be compromise of moral
principles. The main concern is that of the patient’s best interests.
In Andrew’s case, it is more difficult to arrive at an ethical position on the
role of the family in deciding what would be in his best interests than it is in
cases of withholding or withdrawal of treatment. This is in part because the
family is involved in the care at home, care which is becoming increasingly
difficult and ultimately impossible. Also the option of terminal sedation is not
a straightforward route as it contravenes Andrew’s wish to remain lucid"