Obligations to treat, personal autonomy, and artificial nutrition and hydration.

Personal autonomy and the right of self-determination are the basis of the right to refuse treatment. They do not grant the right to demand treatment that the responsible doctor regards as not clinically indicated. 'Best interests' operates as a test in relation to patients who are incompetent. The doctor-patient relationship is a joint enterprise with the aim of improving patient welfare as clinically judged, but only to the extent permitted by the patient. The decision of the Court of Appeal in the case of R v General Medical Council (GMC) ex parte Burke (2005) is explored.