No medical treatment will be forced upon a prison hunger striker to keep him alive and healthy, as his protest enters its second month at Christchurch Men's Prison.
High Court judge Justice Graham Panckhurst described it as "a difficult and distressing case" as he ruled today that there could be no medical intervention because 57-year-old All Means All does not consent.
All has been on his hunger strike since starting a four-month jail sentence on May 28, after he was convicted on six charges of threatening to kill Prime Minister John Key in a series of letters.
He is refusing food because he accuses a detective of misconduct in giving evidence at his trial. He had also threatened a hunger strike at an earlier trial on similar charges.
The Corrections Department and Canterbury District Health Board sought a declaration from the court on how they should handle the matter.
Justice Panckhurst ruled that the hunger strike did not amount to a form of suicide.
All told the hearing in the High Court at Christchurch that he loved life and wanted to live.
"But everyone has a fight at some stage in their life. Mine is that I am prepared to die if need be."
Whether All's case was sensible or not was beside the point, said the judge. He was conducting a protest to bring pressure on a person he believed was guilty of misconduct.
He has refused food and water, and has been admitted to hospital several times, where he has agreed to eat and drink. The hunger strike has resumed each time he has been returned to prison.
All has now been asked whether he will consent to being given hydration and food at the prison's medical centre or at Christchurch Hospital. He has said no.
He has also told the authorities that he is not to be hydrated or given food if he becomes unconscious and incapable or refusing consent before his sentence ends on July 28.
Justice Panckhurst referred to reports by four psychiatrists who have examined or tried to examine All. In at least one case, All would not co-operate.
They generally reported he was "doggedly determined", but had no psychiatric disorder and no treatment was warranted.
One said that All showed a degree of rigidity in his thinking style and approach to problem solving, but he retained the capacity to consent to or refuse medical treatment.
All adamantly opposed the making of a declaration that might open the way for an intervention in his hunger strike. He relied upon the rights enshrined in the New Zealand Bill of Rights, and said intervention would breach his right to freedom of thought, or to adopt and hold opinions without interference.
All denied his hunger strike amounted to deliberate infliction of self-harm, or was a form of suicide.
He refused emergency treatment or palliative care, even at the point where he is unconscious and incapable of confirming his refusal.
Justice Panckhurst reviewed the provisions of the Bill of Rights, and medical codes of practice which said that medical intervention could only take place with the patient's consent.
He noted an international declaration concerning hunger strikes which said that forcible feeding was never ethically acceptable, and amounted to inhumane and degrading treatment.
Justice Panckhurst ruled there was no reason to impose a limit on the right to refuse medical treatment. It was regrettable but inevitable that prison staff would have to live with the resulting anguish.
As part of his ruling on the declaration sought by the Canterbury District Health Board, he said those "owing a duty of care" to All would have a lawful excuse for not providing medical treatment to him while he continued to not give informed consent.
All represented himself at both his District Court trials. He was found guilty at the first one and fined $20,000, but none of that has been paid.
He thanked the judge, Judge Jane Farish, when she jailed him for four months at the sentencing for his second trial.
He will serve half of a four-month sentence, and will be due for release on July 28.
- The Press