Court of Protection Rules Life Sustaining Treatment Can Be Stopped For Patient In ‘Minimally Conscious State’

A High Court judge sitting in the Court of Protection in Preston has authorised the withdrawal of treatment from a 72-year-old woman who is in a ‘minimally conscious state’ after sustaining an aneurysm when she fell last November.

A Judge was asked to decide whether doctors could stop providing treatment by the woman’s two daughters and partner who say that the treatment is prolonging an existence without quality of life.

However, the case was complicated by the fact that the sisters of the woman did not support her daughters’ view that treatment was no longer in her best interests.

The woman, who is being treated in the north of England but cannot be identified for legal reasons, suffered a fall in November 2016. After suffering from headaches after her fall, a CT scan revealed an aneurysm and she then fell into her current state.

For the last ten months, the woman has been on a high-dependency hospital ward where she has received clinically assisted nutrition and hydration through a nasogastric tube. Her daughters and partner asked the Court to approve the withdrawal of the treatment and for the woman to receive palliative care in a hospice.

At the Court of Protection, Mr Justice Hayden ruled that treatment could now be stopped after hearing evidence from medical experts, the woman’s sisters and her children and partner.

Mathieu Culverhouse, a specialist Court of Protection lawyer at Irwin Mitchell representing one of the woman’s daughters, said:

Expert Opinion

“In these highly sensitive cases, there are no winners or losers. The court’s task is to review all the available evidence, in particular the evidence of those who were closest to the person concerned, in order to reach a clear view as to who the person was and what they would have wanted, before making a decision about what is in their best interests.

"In this case, after hearing all the evidence presented to the court by the family and medical experts, the judge has decided that that withdrawing the life sustaining treatment is in my client’s mother’s best interests given her current quality of life and her previously expressed wishes and feelings. The patient’s human rights are always fully considered in such cases.

“Whilst the court has dealt with the case very sensitively, my client and her sister have found it distressing and painful to have to go to court to fight for their mother’s wishes to be respected, and they hope that in future a different way can be found to resolve cases such as this, so that other families do not have to go through the same ordeal.” Mathieu Culverhouse - Partner

During the hearing, one of the woman’s daughters told the court that she believed her mum had ‘gone.’ She described her mother as a ‘force to be reckoned with’ before her fall in November.

She also told the court: “She wasn’t frightened to stand up and say what she thought. She wasn’t anything like a little old lady. She wasn’t a ‘sit there in front of the TV sipping tea’ sort of woman. She was a ‘knock on the council offices’ door’ type of person.”

The court heard that the woman had lost her husband in 1993, and how he had made the decision to have no further medical intervention, a decision that the woman had complied with.

Speaking about this in court, the woman’s daughter said: “My mum was 100% behind my dad’s decision. She was full of admiration for his courage in doing what he did. She sat with him for three days while he died. With that history, I don’t think we could see more clearly what to do now.

“We’ve heard a lot about the patient, but that isn’t my mum. It’s really important that my mum is brought into these proceedings as much as possible.”

Arrangements will now be made for treatment to be withdrawn in line with national clinical guidelines.  The family ask that their privacy is respected at this difficult time.

In 2015, Mr Justice Hayden was involved in a landmark ruling where he ruled in favour of a woman, also represented by Irwin Mitchell, and approved the withdrawal of treatment being received by a 68-year-old woman who was at the end stages of multiple sclerosis.

This landmark ruling was the first time such a decision has been made to withdraw life sustaining treatment from a person in a minimally conscious state.

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