SHALL is mandatory language, under the law. The Congressional compromise in the law (cited in one of the Federal Court decisions) was the SHALL regarding an injunction to reinsert the feeding tube or otherwise provide sustenance and hydration. That was watered down to discretionary MAY, but it was assumed that because they were ORDERED to undertake a de novo review, that they would have to preserve the patient, lest the issue become moot. The Federal court prejudged the case without performing the de novo review it was ordered to o.
Ok, I give. You probably know more than I do when it comes to legal terminology. :-)