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Dean Gregory v Nottingham University Hospitals NHS Foundation Trust & Ors

[2023] EWCA Civ 1262
A very sick baby was on life support. Doctors said it was causing her pain and wouldn't help her get better. A judge agreed, and the baby's dad tried to appeal, but the appeal court said the judge had made the right decision because there was enough evidence already.

Key Facts

  • Indi, a baby girl born with multiple severe health conditions (including a mitochondrial disorder causing progressive brain damage, heart defects, and ventriculomegaly), is critically ill and on life support.
  • The hospital applied to the court to withdraw life support, arguing it was not in Indi's best interests due to the severity and irreversibility of her conditions and the pain caused by treatment.
  • Indi's father opposed the application, arguing that the court lacked sufficient evidential basis, and sought to adduce evidence from multiple experts.
  • The judge found that Indi was experiencing significant pain and distress from the treatment, that her condition was incurable, and that further treatment was futile.
  • The judge refused the father's application for additional expert evidence, concluding that the existing medical evidence was unanimous and sufficient.
  • The father appealed the judge's decision, raising grounds of inadequate scrutiny, inequality of arms, and discrimination.

Legal Principles

Best interests of the child are paramount in medical treatment decisions for minors.

Inherent jurisdiction of the Family Court

Strong presumption in favor of preserving life, but treatment causing increased suffering with no commensurate benefit may be refused.

Manchester University NHS Foundation Trust v Fixsler [2021] EWHC 1426

Expert evidence is only necessary to assist the court; the court may refuse if evidence is sufficient.

Part 25.4(3) Family Procedure Rules 2010

Equality of arms is a principle of fairness but doesn't override rules on admissibility of evidence.

Article 6 ECHR (implicitly)

The UN Convention on the Rights of Persons with Disabilities has an interpretive role in relation to Article 2 ECHR, but does not automatically equate withdrawal of life-sustaining treatment with discrimination.

UN Convention on the Rights of Persons with Disabilities and Article 2 ECHR

Outcomes

The Court of Appeal refused permission to appeal.

The Court found that the judge had given the case anxious scrutiny, that the medical evidence was sufficient and unanimous, and that the father's proposed grounds of appeal had no real prospect of success.

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