Supreme Court rules on who can decide to withdraw life-sustaining treatment

3rd August 2018

A hugely important decision was handed down by the Supreme Court this week, affecting what families can do when a loved one is on life support. It was ruled that families and doctors can agree amongst themselves to end life sustaining care – without having to make a time-consuming and expensive application to Court.

The position previously was that official permission needed to be sought from the Court of Protection to remove nutrition and hydration, as well as other forms of intervention, if a patient was in a vegetative or minimally conscious state. This was the case even if the patient’s family and doctors agreed that removing these measures was in the patient’s best interests and indeed even if the family were adamant that this is what the patient would have wanted. Such applications often took several months to be processed by the Court, something which could be very distressing to relatives already facing seeing a loved one in such a condition.

The Supreme Court considered the sad case of Mr Y, previously a fit and healthy 52 year old who suffered an unexpected heart attack and was deemed unlikely to ever regain consciousness. His family were all in agreement that he would not want to continue living in such a state. His doctors agreed that it was not in his best interests to use artificial measures to prolong his life in this way.

The Official Solicitor, who is instructed on behalf of people who lack mental capacity, argued that Mr Y’s human rights would be breached if life-sustaining treatment was removed without Court authority. However, the Supreme Court disagreed, and ruled that if everyone was in agreement and the case was straightforward, the decision could be left to the family and doctors. Only where there was disagreement as to the course of action or the prognosis did a patient need to be referred to the Court of Protection.

Such a decision should be a relief to people who would otherwise worry about what might happen to them if they were to be placed on life support. Many people are increasingly adamant that they do not want to be kept alive “at any cost” and in particular do not want to put their family through the trauma of watching them suffer. The decision should also help to reassure families if a relative is in this condition, knowing that they can follow their wishes for a peaceful death, if so desired.

The decision reconfirms how vital it is to make your wishes about end-of-life care known while you are able to. It might be a difficult conversation, but it is recommended that you let family, friends or your doctor know what you would like to happen if you suffered an illness or accident which left you requiring life support. In particular, you should consider making a Lasting Power of Attorney (LPA) for Health and Care decisions. In the event that you did lose capacity to make your own decisions about medical treatment, this would allow you to appoint someone you trust to communicate your wishes about the sort of treatment you would – and would not – want to receive. This would also provide assurance to your family and friends, who could be happy that they were putting your wishes into effect.

For advice about LPAs or mental capacity, please get in touch.

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