A high court judge ruled that doctors may withdraw life support from a 66-year-old man suffering from brain damage or prolonged disorder of consciousness on Tuesday.
The man, who remained anonymous under the pseudonym ‘XY’ in the judgement, was admitted to a hospital, which was a part of the Whittington Health NHS Fund, on December 18, 2023, and was suffering from pneumonia at the time. Not long after his admission to the hospital, XY suffered a heart attack, which resulted in multiple organ failure, damaging his brain, causing seizure activity, and eventually placing him in a comatose state. Though XY emerged from the coma, he never regained consciousness and entered a state known as a prolonged disorder of consciousness. Despite XY’s family showing video evidence of what they believed to be signs of consciousness, experts determined these were merely reflex reactions to stimulation.
The case centred on whether the life-sustaining care provided to XY should be removed. Doctors and experts associated with the Whittington Health NHS Fund argued that the care should be removed, as it was costly and causing XY potential pain and that he had no chance of recovery. Experts stated that maintaining the life-sustaining care would simply prolong XY’s death, as opposed to doing him any benefit.
XY’s family, on the other hand, sued on the basis that the life-sustaining care could not be revoked from him. This was because section four of the Mental Capacity Act 2005, a section allowing loved ones of patients to make decisions regarding their care, required that weight be given to what the patient would have wanted. XY comes from a Muslim family, and Islam prohibits human interference in the process of death. XY’s family stated that this would have been XY’s wish, and further that he would have wanted to be present for his family as long as possible to provide them comfort.
Notably, XY’s human rights under Article Two (the right to life), Article Three (protection from inhuman or degrading treatment) and Article Eight (the right to respect for a private and family life) of the Human Rights Act 1998 were also triggered in this case. The Mental Capacity Act and the Human Rights Act essentially required that where possible, the effect should be given to the person’s wishes, except where it was overwhelmingly not in their best interest according to medical evidence.
Justice Hayden, the judge ruling in this case, held that the life-sustaining care being provided to XY should be withdrawn. He held that despite XY’s probable wishes, the medical evidence overwhelmingly showed that it was not in his best interest to continue treatment and to cause him further pain without a chance of recovery. One doctor who worked closely with XY and his family stated that he felt it was contrary to the Hippocratic oath, which states that doctors swear to not harm patients, to continue treatment. A possible alternative path to simply withdrawing treatment entirely was also explored by Justice Hayden, by preventing XY from receiving any further antibiotics and letting him die naturally of bacterial infection. Though this was an option closer aligned with XY’s probable wishes and that of his family, because his death would occur without human intervention, Justice Hayden concluded that it was contrary to the integrity XY had shown in life. As such, Justice Hayden ruled that life-sustaining treatment should be withdrawn from XY.
Justice Hayden was remorseful about the ruling and XY’s future passing. He said that XY:
had an unshakeable thirst for life and a striking generosity of spirit… His delight in his thirteen grandchildren has been every bit as great as that in his children… His local community was central to his life and he was quick to identify and help those in need. He attended the mosque daily, frequently five times per day. His Islamic faith was profoundly important to him… He also did important humanitarian work providing water to remote villages in Bangladesh.
