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Court approves withdrawal of treatment from patient in minimally conscious state

‘Landmark decision’ in Court of Protection

Mr Justice Hayden, sitting in the Court of Protection, has authorised the withdrawal of treatment from a 68-year-old woman who is at the end stages of multiple sclerosis. It is believed that this is the first time such a decision has been made to withdraw life sustaining treatment from a person in a 'minimally conscious state'. The judgment in Re N [2015] EWCOP 76 is here.

The daughter of the patient, Mrs N, had applied to the court for a declaration determining whether it was in the best interests of Mrs. N to receive life sustaining treatment by means of Clinically Assisted Nutrition and Hydration (CANH) currently provided through a percutaneous endoscopic gastrostomy (PEG) tube.  The daughter, M, strongly believed that the continuation of this intervention was contrary to her mother's best interests.

Twenty-three years had elapsed since Mrs N had first been diagnosed with multiple sclerosis. In early 2015 M concluded that the situation for her mother was intolerable and she no longer remained alive in any sentient sense.

Mathieu Culverhouse, an associate at Irwin Mitchell representing M, said:

"There are no winners or losers in sensitive and emotional cases like this.

The situation is distressing for all of those involved but after hearing all the evidence from the family, carers and medical experts presented to the court, the Judge has decided that that withdrawing the life sustaining treatment is in the woman's best interests given her current quality of life.

"While this is clearly distressing for her daughter, she is relieved that the court has been able to review and examine the expert medical evidence available and hear detailed legal argument before making a decision which will now end her mother's suffering and indignity.

"This landmark decision is the first time that the Court of Protection has agreed to withdraw treatment from someone receiving life sustaining treatment while considered by medical experts to be in a 'minimally conscious state'. However, all cases of this kind are decided on their own facts and Judges will always examine the all the evidence presented to them, including that presented by the patient's family affected, on an individual basis."

Mrs N was represented by the Official Solicitor, who supported the daughter's application.

The judgment is here.

20/11/15