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Landmark Ruling As Supreme Court Backs Doctors And Families In End-Of-Life Decisions

Landmark Ruling As Supreme Court Backs Doctors And Families In End-Of-Life Decisions

The ruling means health authorities will not have to spend months and tens of thousands of pounds defending against potential appeals

Nathan Standley

Nathan Standley

The Supreme Court of the United Kingdom has ruled that legal permission will no longer be required to end care for patients in a permanently vegetative state.

Previously, doctors would have to make legal applications to the Court of Protection to protect them from legal action, even if they and the family had agreed that it would be in the patient's best interests to withdraw end-of-life support.

The Court of Protection has been ruling on such cases for over two decades but the process can take many months, even years, and costs the health authorities about £50,000 ($65,500) just to avoid a potential appeal.

This ruling by the Supreme Court, the UK's highest court, could affect the lives of the thousands of people who are kept alive by medical interventions each year and their families.

What does this decision mean?

This means it will now be easier for doctors to remove the food and liquid keeping a patient alive once they and the family are in agreement that care should be withdrawn.

A vegetative state is essentially when a person is awake but is showing no signs of awareness.

PA

Anyone in a vegetative state may still have the capacity to open their eyes and retains basic reflexes, and may fall asleep and wake up at regular intervals. Their heartbeat and breathing may also be regulated without assistance - however they will likely show no sign of experiencing emotions, or display any meaningful responses to stimuli such as voices, or follow objects with their eyes.

When a person remains in this state for over four weeks, it is known as a continuing (or persistent) vegetative state. This is described as permanent if it happens for more than six months, if caused by a non-traumatic brain injury, or more than 12 months if caused by a traumatic brain injury.

Although not impossible, recovery from being in a permanent vegetative state is thought to be extremely unlikely.

Why has this decision been taken?

The ruling was made in the case of a banker, identified only as 'Mr Y', who suffered a heart attack in June 2017 at the age of 52.

The court heard he had been very active before then, despite having a stressful profession, and enjoyed running, skiing and going to the gym as well as music and rock concerts. He had left no living will or indication of what should happen to him should he be affected by a sudden debilitating illness.

It was deemed that he was unaware of both himself and the environment around him after the cardiac arrest and it was extremely unlikely that he would ever regain consciousness.

PA

The court heard his wife and their two children, as well as his brother and sister, had accepted that he would not want to live in a vegetative state with severe disabilities and doctors agreed.

The case was pushed quickly through the courts because of the man's condition after an appeal against the family and doctors' decision was made on behalf of Mr Y by the official solicitor.

Although the man died before a ruling could be made, the courts decided to carry on with the case because it was an important issue that needed to be resolved.

That appeal was dismissed after the court accepted the NHS trust's request to the High Court asking that doctors should not have to go to the Court of Protection once they and the patient's family agrees that withdrawing care is the best thing to do.

Presiding over the case of Mr Y, Lady Black ruled that there had been no violation of his rights under the Human Rights Convention.

Featured Image Credit: Jay Galvin (Creative Commons)

Topics: UK News, law, Health