The seminal case of Bland below illustrates the difficult choices to be made where a patient lacks competence due to a permanent vegetative state (PVS). The most recent advice from the GMC, entitled Treatment and Care Towards the End of Life, came into force in July 2010. The advice builds upon common law decisions, ethical principles, the Mental Capacity Act 2005 and the Incapacity Act 2000 together with the requirements of the Human Rights Act 2000. At the time of writing, this guidance represents the most up-to-date guidance in relation to end-of-life decisions. The guidance states that medical professional must not be motivated by desire to bring about the patient's death, and must start from a presumption in favour of prolonging life. Therefore, all reasonable steps must be taken to prolong a patient's life but there is no absolute obligation to prolong life irrespective of the consequences of the patient's views, if they are known or can be found out.