Judge rules life support can end for 20-year-old with brain injury after pub garden fight

A judge has ruled that doctors can lawfully stop treating Andy Casey who is on life support with a brain injury following a fight in a pub garden.

The 20-year-old roofer from Mitcham, south-west London, was involved in a fight in a pub garden on 9 July, where he was 'punched to the head' and 'fell to the ground'.

During a private trial in the Family Division of the High Court in London, Mr Justice MacDonald heard that Mr Casey had remained on a ventilator since being injured.

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However, on Tuesday (12 September), he ruled that Mr Casey's brain stem function has died and he is therefore dead.

Barrister Abid Mahmood of St George’s University Hospitals NHS Foundation Trust - who has responsibility for Mr Casey’s treatment - asked the judge to rule if it would be lawful to stop ventilation and care.

The lawyer said that Mr Casey is dead, according to brain stem tests by two specialists.

In a written ruling, Mr Justice MacDonald said: “Whilst I understand fully the conclusions that the family and friends of Mr Casey have, in their sorrow, drawn from his movements and apparent responses to the ventilator, having regard to the totality of evidence before the court, I am also satisfied that what the family are seeing are in fact well-recognised base reflexes that can survive brain stem death.

“Cruelly, the flattering voice of hope convinces those that love Mr Casey that these are signs that Mr Casey is not dead.

“With regret, I am satisfied that the brain stem testing undertaken… demonstrate(s) that he is.”

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Mr Justice MacDonald said Mr Casey 'died on 16 July 2023 at 11.51pm'.

He said: “I understand that this will come as a bitter disappointment to Mr Casey’s family and friends.

“The now blurred boundary between life and death can be delineated by reference to philosophy, to ethics or to the cardinal tenets of the world’s great religions.

“But the task of this court is to consider whether Mr Casey has crossed over that boundary for the purposes of the law.

“I recognise that this is a tragedy for his family and friends and whilst I am certain that it will offer little comfort, they have my profound sympathy.”

The family say they will appeal after failing to persuade the High Court judge that life-support treatment should continue.

Mr Casey's sister, Christine, 27, told the judge: "He reacts to pain.

"I showed the judge so many videos. How can someone who reacts to pain be dead?

"We are looking at an appeal."