10:17, February 25 285 0 theguardian.com

2018-02-25 10:17:05
Court to hear case of banker kept alive against family's wishes

The case of an investment banker who suffered severe brain damage following a heart attack will be heard by the supreme court on Monday in a test of whether judges need to authorise the withdrawal of life support treatment.

The legal challenge by the official solicitor, brought in the face of opposition by the man’s family and his doctors, had been accelerated through to the UK’s highest court because of his condition. The man, “Mr Y”, has, however, since died.

His end of life dilemma is one faced by thousands of people every year. The case was brought because families not only have to endure the protracted trauma of seeing their relatives reduced to a vegetative state but must then undertake costly and time-consuming legal action to obtain judicial permission to turn off machines that sustain their lives.

In November, the high court ruled that the court of protection does not need to be consulted in cases, such as that of Mr Y, where clinicians and the patient’s family agree that it is not in the best interests of the patient to be kept alive in a coma.

The banker was 52 when had a cardiac arrest in June last year. Before then, he was very active despite working long hours in a stressful profession. He ran and skiied, regularly went to the gym and was said to have loved music and rock concerts. He had not left a living will or any instructions on what should happen to him in the case of sudden illness.

After the heart attack, he was said to be unaware of either himself or his environment. It was deemed highly improbable that he would regain consciousness.

His wife, their two children, and his brother and sister, the high court heard, all accepted that Mr Y would not want to live in a vegetative or minimally conscious state with profound disabilities.

“He would hate to be helpless and dependent on other people for his daily needs,” the judgment said. “He would not want to live in a care home.”

The judge concluded there was no legal obligation “that all cases concerning the withdrawal of CANH [clinically assisted nutrition and hydration] from a person who lacks capacity must be sanctioned by the court”.

The high court judge, Mrs Justice O’Farrell, cited a landmark judgment in another case, saying it had clearly established that principle. Where doctors had obeyed the Mental Capacity Act and good medical practice, where there was no dispute with the family or others close to the patient, and there were no other doubts or concerns, there was no need to bring the matter before the court, she said.

But the official solicitor, who formally represents the separate interests of the patient, Y, disagreed. The official solicitor’s office has declined to comment on the case.

The original high court application was brought by Vikram Sachdeva QC on behalf of the unnamed NHS trust that had been treating the man.

In 1993, in the case of Anthony Bland, a Hillsborough survivor who was left in a persistent vegetative state, the courts established that it was legal to stop providing treatment – including food and water – if it was deemed to be in the patient’s best interests.

The supreme court hearing on Monday and Tuesday will be heard by five justices, Lady Hale, Lord Mance, Lord Wilson, Lord Hodge and Lady Black. Judgement is likely to be reserved.

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