Britain's highest court has ruled in favor of a hospital that gained court approval to withhold treatment from a terminally ill man despite the family's opposition. In a unanimous judgment handed down on Wednesday, the Supreme Court ruled that the Court of Appeal was correct in allowing Aintree University Hospital in Liverpool to withhold treatment from David James, 68, who suffered colon cancer, organ failure and a stroke, among other problems. James' doctors estimated he had a 1 percent chance of survival and applied to the Court of Protection for a legal declaration allowing it to discontinue some types of treatment, like restarting his heart if it stopped and a kidney replacement therapy. The court rejected the application on Dec. 6, but 15 days later the Court of Appeal reversed the decision. By that time, James' condition had worsened, and he died on Dec. 31. Until his death, James had been dependent on a breathing machine, had a tube to provide him with basic nutrition and hydration. His doctors said "daily care tasks" caused him pain and suffering. James' family argued that his care should have continued. The Supreme Court judges concluded that where treatment is futile, "it would be in the best interests of the patient to withdraw or withhold life-sustaining treatment," even if this results in the patient's death. James' family said they believed he would have wanted to continue being treated and that he had not reached the point where treatment was hopeless. But lawyers for the hospital said James had severe physical and neurological damage, was steadily deteriorating and that further invasive treatments would put him at greater risk. "When you can't consent, the law says we only treat you when it's in your best interests," said Penney Lewis, a professor and medical law expert at King's College London. She said British courts have previously ruled that preserving life is not always in the patient's best interests and that judges must weigh whether treatment would have any benefit for the patient, even if it doesn't cure them. Though some treatments which result in minimal improvement might be considered worthy for some patients, such as those in intensive care, Lewis said that criterion wasn't met in James' case by the time the case went to the Court of Appeal, which ruled he had no chance of improving. "The time had indeed come when it was no longer premature to say that it would not be in his best interests to attempt to restart his heart should it stop beating," the judges wrote in their decision.   e t5? oy?q?s system to kill those infected cells, they wrote. Barouch's results hinted at such an effect, they noted. Virus levels dropped faster in the monkeys than they do when people get standard HIV drugs, and when the monkey virus returned, it generally didn't reach its pre-treatment levels. Barouch also found virus levels reduced in cells and tissues after treatment.   The findings of the two studies are "provocative" about prospects for attacking HIV's hiding places, Deeks said in a telephone interview. "These studies raised more questions than they answered," he said. "But that's how science advances."   so-b?fn?q?s.0pt; font-family:"Verdana","sans-serif";mso-fareast-font-family:"Times New Roman"; mso-bidi-font-family:"Times New Roman";color:#333333;mso-fareast-language:EN-GB'> law and ethics at Oxford University, believes children couldn't possibly have the capacity to make an informed decision about euthanasia since even adults struggle with the concept.   "It often happens that when people get into the circumstances they had so feared earlier, they manage to cling on all the more," he said. "Children, like everyone else, may not be able to anticipate how much they will value their lives if they were not killed." There are others, though, who argue that because Belgium has already approved euthanasia for adults, it is unjust to deny it to children. "The principle of euthanasia for children sounds shocking at first, but it's motivated by compassion and protection," said John Harris, a professor of bioethics at the University of Manchester. "It's unfair to provide euthanasia differentially to some citizens and not to others (children) if the need is equal." And Dr. Gerlant van Berlaer, a pediatric oncologist at the Universitair Ziekenhuis Brussels hospital, says the changes would legalize what is already happening informally. He said cases of euthanasia in children are rare and estimates about 10 to 100 cases in Belgium every year might qualify. "Children have different ways of asking for things, but they face the same questions as adults when they're terminally sick," van Berlaer said. "Sometimes it's a sister who tells us her brother doesn't want to go back to the hospital and is asking for a solution," he said. "Today if these families find themselves (in that situation), we're not able to help them, except in dark and questionable ways." The change in the law regarding people with dementia is also controversial. People now can make a written declaration they wish to be euthanized if their health deteriorates, but the request is only valid for five years and they must be in an irreversible coma. The new proposal would abolish the time limit and the requirement the patient be in a coma, making it possible for someone who is diagnosed with Alzheimer's to be put to death years later in the future. In the Netherlands, guidelines allow doctors to euthanize dementia patients on this basis if they believe the person is experiencing "unbearable suffering," but few are done in practice. Dr. Patrick Cras, a neurologist at the University of Antwerp, said people with dementia often change their minds about wanting to die. "They may turn into different people and may not have the same feelings about wanting to die as when they were fully competent," he said. "I don't see myself killing another person if he or she isn't really aware of exactly what's happening simply on the basis of a previous written request (to have euthanasia). I haven't fully made up my mind but I think this is going too far." Penney Lewis, a professor and medical law expert at King's College London, agreed that carrying out euthanasia requests on people with dementia once they start to worsen could be legally questionable. "But if you don't let people make decisions that will be respected in the future, including euthanasia, what you do is encourage people to take their own life while they have the capacity or to seek euthanasia much earlier," she said. In the past year, several cases of Belgians who weren't terminally ill but were euthanized — including a pair of 43-year-old deaf twins who were going blind and a patient in a botched sex change operation — have raised concerns the country is becoming too willing to euthanize its citizens. The newest proposals have raised eyebrows even further. "People elsewhere in Europe are focused on assisted dying for the terminally ill and they are running away from what's happening in Belgium," Lewis said. "If the Belgian statutes go ahead, this will be a key boundary that is crossed."