Tony Bland was receiving what was referred to then as 'artificial feeding' and would now be called 'clinically assisted nutrition and hydration' (CANH). Tony had a nasogastric tube. He was in what was then called a 'persistent vegetative state' (PVS) and, because his condition persisted long enough to be considered clinically irreversible, would now be called a 'permanent vegetative state. This chapter examines legal fictions, developments and gaps. It focuses on various distinctions explicitly or implicitly drawn in Bland, the five safeguards accepted by their Lordships and the approach in other jurisdictions. The chapter also analyses the withdrawal of life-sustaining treatment from patients in PVS using the Principle of Generic Consistency. It concludes that it is lawful to withdraw CANH from a patient in PVS using an alternative legal route in which it is explicitly accepted that those in PVS count for less than those who display some cognitive-functional ability.