The recent Western Australian  Supreme Court ruling on whether Brightwater, the organisation caring for quadriplegic Christian Rossiter, could accede to Mr Rossiter’s wish to refuse nutrition will no doubt be considered a landmark. The decision upholds the general (and generally accepted) principle that a person with the (legal) capacity to make a decision can decide not to have a medical procedure. In this case the medical procedure is one that allows Mr Rossiter to be fed via a percutaneous endoscopic gastrostomy (PEG) tube. A paradoxical result may be that now people such as Mr Rossiter have had their right to refuse treatment affirmed, they may be less inclined to assert that right because the little bit of hope may have eased their suffering enough