“He deserves a chance”? Continuities and shifts in decision-making about life-sustaining treatment

the family in this case was holding on to the smallest glimmer of hope to stave off the devastating certainty of loss if their loved one died. Like so many people, they also had a belief that their family member was the one who would defy the odds – he is a ‘fighter’ whose sheer determination will enable him to overcome catastrophic brain injury. They also conveyed their strong sense that the person they knew is still ‘in there’, in the warm and moving body, that looks so different from how one imagines a classic ‘coma’.

Available options and best interests in a disputed end-of-life treatment case

By Celia Kitzinger, 21 March 2022 The judgment is now published: London North West University Healthcare NHS Trust v M & Ors [2022] EWCOP 13 (21 March 2022) On 14th March 2022, I watched a one-day final hearing about a young man in a prolonged disorder of consciousness from which (doctors say) he will never recover.  Continue reading “Available options and best interests in a disputed end-of-life treatment case”

Family dispute about life-sustaining treatment: A directions hearing

By Jenny Kitzinger, 22nd December 2021 The hearing I attended on 21st December 2021 before Ms Justice Russell was yet another case which underlines the dangers of not planning ahead for possible future loss of capacity.  This is what can happen to any of us, at any time, if we are suddenly brain injured, whether fromContinue reading “Family dispute about life-sustaining treatment: A directions hearing”

Family witnesses in court: Four reflections on Re AH (A Rehearing)

Suggesting that the family is lacking in objectivity because they are in some way psychologically compromised serves the purpose of undermining and discrediting their evidence.  This was not necessary to powerfully argue the Trust’s case that ongoing life-sustaining treatment is not in AH’s best interests. The medical evidence stood alone.

Navigating a family feud on P’s death-bed

By Celia Kitzinger, 9th November 2021 She’s in her eighties, with significant cognitive decline,  and delirium secondary to numerous infections and “in all likelihood in the last weeks of her life,” said the judge.  She lacks capacity to make her own decisions about who she has contact with. One of her daughters, Ann[1], and Ann’s daughter (P’sContinue reading “Navigating a family feud on P’s death-bed”

A best interest decision about life-sustaining treatment for a person with profound neurological injury following COVID-19 infection

d is enormous and awful to read about” such that she “will never be able to live outside of residential care” and “things that have been dear to her, she will never be able to enjoy in the way she would have contemplated”.  But he clearly stated that this “hypothetical factual matrix” (i.e. even if these facts are all true), “does not automatically indicate a clear best interests outcome”.   

Court-enforced amputation or patient autonomy?

At the end of the hearing, in her closing summary, Emma Sutton acknowledged that it was a “finely balanced” decision but came down on the side that amputation was NOT in her best interests – most especially as it went counter not only to her current wishes and feelings, but also to her clearly expressed capacitous decisions as recently as last year.  

Faith, Science and the objectivity of expert evidence

“If organisations like Christian Concern are willing to spend time and money on conducting their ‘pro-life’ campaigns via courtroom litigation, and can find experts willing to act for them, there may be very little the Court of Protection can do to prevent them.”

A perspective from the ICU on best interests at the end of life

To the ICU clinician, the facts of this case are notable for their ordinariness. This is obviously an unimaginably sad situation for the person and for the family involved, but this sort of clinical situation evolves every day in intensive care units around the country.

Parents in conflict over life-sustaining treatment for their daughter

The judge invited her mother to choose a pseudonym (for the published judgment) that her daughter might have liked. She is anonymised as “Lilia” – the name of her favourite teddy bear.