Court of Protection Rules Life Sustaining Treatment Must Continue
The family of a brain injured man in his 40s in intensive care has been praised by a Judge after winning a court battle to prevent an NHS Trust from withdrawing kidney treatment which is keeping him alive.
Anne-Marie Irwin, a specialist solicitor at law firm Irwin Mitchell representing the family said: “The family are delighted that the Judge has ruled to preserve life and find that the man’s religious beliefs were relevant in determining his best interests and whether to continue treatment.”
The man, known as P, suffered a cardiac arrest in November 2014 which left him with brain damage and he has been reliant on intensive care ever since.
In January this year St George’s University Hospitals NHS Foundation Trust applied to withdraw the renal replacement treatment which is keeping him alive. They argued that he was in a vegetative state and was not responsive.
However the family instructed law firm Irwin Mitchell to fight the withdrawal of treatment and have always maintained that P is in a conscious state. They said he was known to smile and to respond to their instructions - for example, by moving his hand or turning his head when asked. The family had to seek a court order to be allowed to film P's responses to instruction and the films were used as evidence in court. They argued he should be kept alive, as this would be in accordance with his deeply held views.
At a hearing in the Court of Protection earlier this month to determine whether or not to stop treatment the court heard evidence from experts and P’s family that he is in a minimally conscious state rather than a ‘vegetative’ state, as the Trust had originally diagnosed.
After balancing the pros and cons of continuing treatment, the Judge ruled that it is clear P’s treatment should continue and praised the man’s family for remaining steadfast in their views and for fighting their cause.
In his judgment Mr Justice Newton said he had “reached the clear conclusion that the balance lies strongly in favour of preserving P’s life”. He added that P “gains pleasure and comfort from the love and affection that he receives from his family and that is a continuing illustration not just of his conscious state but also of the importance of the continuation of such treatment.”
Expert Opinion"The family are obviously very relieved that the judge has ruled in their favour. They have never wavered from their opinion that P was responsive and have now been successful in proving that he was in a minimally conscious state as opposed to a vegetative state.
"There is a difference between patients who are in a persistent vegetative state and those that are in a minimally conscious state, which means that they are aware of their surroundings to a certain extent. Where a patient is in a minimally conscious state, the court is required to consider whether continuation of treatment would be in the patient’s best interests. In this case P’s family believe that he would want to remain alive and that he is able to derive quality of life from the time he spends with his family and friends.” Anne-Marie Irwin - Senior Associate
Speaking after the judgment was handed down, P’s family said: “We are pleased that treatment will now continue and thank Mr Justice Newton for carefully considering all of the evidence, including the video footage.
“We remain concerned that we have had to fight this case all the way to court when in our opinion it has always been clear that P is responsive. It is clear that despite his severe condition he has a level of awareness. We think it is only right that he is able to continue receiving treatment.”
The judgment was critical of the NHS Trust for making the application before it had carried out a “SMART” assessment, which would have determined P’s level of awareness and whether he was in a vegetative, or a minimally conscious, state.
Anne-Marie Irwin of law firm Irwin Mitchell endorsed the family's stance and added: “Significantly, this clarification will help families in a similar situation who disagree with medical staff over the diagnosis of their loved ones and could help prevent the need for the courts intervention in some cases."
“The Judge has made it clear that the relevant assessments to determine the exact diagnosis of an individual should be carried out before any court application. This will give the court a full picture of the situation and ensure that any disagreements over a patient’s diagnosis are determined before court action becomes necessary.”
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