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”

When doctors are not willing to offer treatments

By Celia Kitzinger, 13th March 2022 This was an unusual hearing because of its focus on a treatment (clinically assisted nutrition)  that doctors were not willing to offer.   By the day of the hearing, the person at the centre of this case (P) had not received nutrition for 10 days, ever since his nasogastric (NG) tubeContinue reading “When doctors are not willing to offer treatments”

Delay is inimical to P’s welfare: Guidance on clinically-assisted nutrition and hydration for PDoC patients

e of poor practice, and active resistance from some quarters, the court could also make clear that continued provision of medical treatment when it is not in someone’s best interests is an assault, and that clinicians will not be able to rely on the defence in s.5 of the Mental Capacity Act 2005 – meaning that there is a risk to them and to their organisations of claims for damages.

Urgency, delayed decision-making and ethics in the Court of Protection

reatment for patients who are unable to decide for themselves. In England and Wales, they haven’t, or only extremely rarely, been called as expert witnesses. Yet ethics is obviously central to the work of the Court of Protection. And if this hearing is anything to go by, if judges or barristers were willing to call on them, it seems that there could be a place for an ethicist in the courtroom.

Clinically-assisted nutrition and hydration: Decisions that cannot be ignored or delayed

By Jenny Kitzinger, 23rd June 2021 Hearings in the Court of Protection often bring crucial issues into sharp relief in a vivid, poignant and intellectually rigorous way.  This was certainly so in the hearing I observed last week: Case No. 1375980T on 10 June 2021. It concerned GU, a 70-year-old man who sustained a severe anoxic brain injury in AprilContinue reading “Clinically-assisted nutrition and hydration: Decisions that cannot be ignored or delayed”

Ambiguity and uncertainty in clinical reasoning

“So,  I would not only allow but would actively encourage video recording, especially by family members, and especially of observed behaviours the family believe may not have been seen or noticed by clinical observers. If this is openly discussed at an early stage, the clinical team can, at the same time, point out that any recorded material must not be disseminated beyond those people who have a legitimate personal relationship with the patient”

Use of videos in assessing consciousness: A clinical perspective

The pandemic has had very many devastating effects, one of which is that it has denied families the experience of being able to spend time at the patient’s bedside. From the clinical perspective this has had several adverse consequences.