Suffering is without prospect of improvement if this is the
prevailing medical opinion. In other words, if doctors agree that
the patient's condition will not improve.
It is difficult to establish objectively whether suffering is
unbearable. The review committee examines each individual case to
establish whether the doctor could reasonably conclude that the
patient was suffering unbearably.
The doctor and patient must discuss every possible alternative
treatment. As long as a feasible alternative is available, there
is, in a medical sense, a prospect of improvement.
This can be assessed objectively. By contrast, the extent to
which suffering is unbearable is a highly subjective matter.
Nevertheless, where suffering is not obvious either to himself or
to the patient's relatives or carers, the doctor will have to try
to imagine what the patient is feeling and - based on his medical
experience - attempt to assess his suffering objectively.