Although the principle of the sanctity of human life is fundamental and there is a strong presumption in favour of a course of action which would prolong life, this presumption is not absolute or irrebuttable1. The principle may yield in certain circumstances to the principle of self-determination, such as where a competent adult patient refuses to consent to treatment or care by which his life would or might be prolonged2: there is, for example, no obligation on the authorities to prolong the life, by insisting on artificial feeding, of a prisoner of sound mind who goes on hunger strike3.
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