It is understandably common for family members and friends to take a more optimistic view of a patient’s prospects of recovery than the medical professionals involved. A tragic case in which the High Court considered whether it would be lawful to discontinue a 54-year-old woman’s life-sustaining treatment illustrates the issues the courts must grapple with in such circumstances.
The woman had suffered a cardiac arrest and her brain had been deprived of oxygen for over an hour. She had been in intensive care for six months and was said to be in a prolonged disorder of consciousness. The NHS trust responsible for her care applied for a declaration that it would be lawful and in her best interests for life-sustaining treatment to be discontinued. Her daughter opposed the application.
The Court considered evidence from family members and friends, who painted a similar picture of a warm and loving mother, aunt, sister or friend. They stated that she had shown signs that she was getting better and would respond to requests to blink or to squeeze her daughter’s hand. Her daughter described her as ‘a fighter’ who would choose life over death.
However, the medical evidence was that she had suffered generalised brain death, with no prospect of recovery. She would never recognise her family and friends, and there were no outward signs that she felt pain or pleasure. The medical experts were agreed that there was no benefit in continuing treatment and it was in her best interests for it to be withdrawn.
The Court noted that it was established by case law that, if it were not in a patient’s best interests to give treatment, the Court could not give consent to it and it would be lawful to withdraw it. The Court found that the woman had no awareness of her family’s presence: the responses they witnessed were spontaneous rather than purposeful movement. There was no real prospect of recovery of any of her functions and recent brain scans indicated that her condition was deteriorating.
Taking all the facts into account, the Court found that it was necessary and in the woman’s best interests that the application be granted. The futility of treatment and her increasing brain deterioration outweighed the family’s views and what they considered her own views would have been. It was not in her best interests for treatment to continue, and therefore it was lawful for it to be withdrawn.