UK Supreme Court supports hospital withholding treatment to dying man

[JURIST] The UK Supreme Court [official website] ruled [judgment, PDF; press release, PDF] Wednesday that Aintree University Hospitals NHS Foundation Trust [official website] was justified in its decision that withholding certain invasive treatments would be in the best interests of critical care patient David James, despite resistance from the patient's family. James was admitted to Aintree's critical care unit in May 2012 for an infection acquired during his treatment for colon cancer, where he was reliant on ventilator support and suffered multiple severe setbacks. Despite opposition from James' family, the hospital brought proceedings to the Court of Protection [official website] in September 2012. The hospital sought judicial declaration that withholding the specified treatments would be in James' best interest, pursuant to the 2005 Mental Capacity Act [text, PDF; Code of Practice] provision that it may in the best interests of a patient to withhold life-sustaining treatment "where treatment is futile, overly burdensome to the patient or where there is no prospect of recovery." The trial judge ruled against the declarations on December 6, and Aintree appealed. James subsequently suffered "further dramatic deterioration," and the Court of Appeal reversed [judgment, PDF] the decision on December 21, 2012. James died of cardiac arrest only 10 days later. Wednesday's ruling by the Supreme Court subsequently determined that the trial judge was correct in opposing the declarations and that the Court of Appeal was also correct in light of the changed circumstances since the initial ruling.

The issue of medical consent in the UK was recently addressed when the Court of Protection ruled [JURIST report] in August that a vasectomy was "in the best interests" of a man with a learning disability who was unable to provide informed consent as to the procedure. End-of-life and right-to-die issues have also been a contentious topic in Europe. The European Court of Human Rights [official website] ruled [JURIST report] in May that assisted suicide laws in Switzerland fail to provide sufficient guidelines on the extent of the right to die. In August 2012 the High Court of England and Wales denied [JURIST report] a paralyzed man's plea challenging laws prohibiting him from committing suicide. In September 2011 a UK High Court judge ruled [JURIST report] that a woman in a "minimally conscious state" due to brain damage did not meet statutory requirements for her family to discontinue her life support.

 

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