by Dr. Eowyn
Ben Morgan reports for the Evening Standard that on July 30, 2018, the UK’s Supreme Court ruled that in cases where families and doctors are in agreement, medical staff can remove feeding tubes from patients in a permanent vegetative state, without the patient’s consent and without consulting a judge.
UK’s highest court made that ruling by upholding a decision that a financial analyst, 52, with an extensive brain injury (PDOC: prolonged disorder of consciousness), who is identified only as Mr. Y, should be allowed to die without his family going before a judge. The man had a cardiac arrest as a result of coronary artery disease.
PDOC covers patients in a coma, vegetative state and minimally conscious state after a brain injury.
Experts agreed it was highly improbable that Mr Y would re-emerge into consciousness and – even if he did – he would have profound cognitive and physical disability and always be dependent on others.
Mr Y had not drawn up any advance decision to refuse treatment but his family were firmly of the view that he would not want to be kept alive given the poor prognosis. His family and medical team agreed it would be in his best interests for clinically assisted nutrition and hydration (CANH) to be withdrawn, with the result that he would die within two to three weeks.
Richard Gordon QC, for the Official Solicitor, said: “This case is not about whether it is in the best interests of a patient to have CANH withdrawn. It is about who decides that question.”
Supreme Court judge Lady Black said: “Having looked at the issue in its wider context as well as from a narrower legal perspective, I do not consider that it has been established that the common law or the ECHR (European Convention on Human Rights), in combination or separately, give rise to the mandatory requirement…to involve the court to decide upon the best interests of every patient with a prolonged disorder of consciousness before CANH can be withdrawn.”
The court’s ruling can have an impact on thousands of UK families whose loved ones are in a vegetative state.