Guy's and St Thomas' NHS Foundation Trust v VA & Anor
[2023] EWCOP 39
VA (Medical Treatment), Re
13 October 2023
[2023] EWCA Civ 1190
Court of Appeal
A seriously ill woman's family disagreed with doctors about her treatment. A judge initially agreed with the family but later changed their mind, deciding it was best to let the woman pass peacefully instead of continuing aggressive treatment. The family tried to appeal but lost; the court said the judge made a fair decision based on the circumstances.
Key Facts
- •VA, a 78-year-old woman, lacked capacity to consent to medical treatment.
- •VA suffered severe hypoxic brain injury resulting in a profound disorder of consciousness.
- •Two treatment options were considered: extubation with palliative care or tracheostomy with PEG tube.
- •There was a conflict between the hospital trust and VA's family regarding treatment.
- •Initial court order authorized tracheostomy, but this was later challenged.
- •Subsequent court hearing reversed the decision, ordering extubation and palliative care.
- •VA's family appealed the decision, arguing procedural unfairness and violation of human rights.
Legal Principles
Best interests of the incapacitated person are paramount.
Mental Capacity Act 2005, s.1(5)
Decisions regarding medical treatment must be made in accordance with the best interests of the incapacitated person.
Mental Capacity Act 2005
Court considers wishes and feelings of the incapacitated person, but these are not determinative.
Burke v GMC [2005] EWCA Civ 1003, A Local Authority v JB [2021] UKSC 52, Aintree v James [2014] AC 591, NW London CCG v GU [2021] EWCOP 59
In cases involving personal welfare, the general rule is that there will be no order as to costs.
Court of Protection Rules 2017, Rule 19.3
Court considers the conduct of parties when deciding costs on appeal.
Civil Procedure Rules, Part 44, rule 44.2
Outcomes
Appeal dismissed.
The judge's decision was deemed fair and based on sufficient analysis of the evidence. The court found that the judge's assessment of VA's wishes and feelings, while succinct, was sufficient given the circumstances.
No order as to costs.
The gravity of the issue, the appellant's conduct, and the overall circumstances justified this decision. The Court followed established practice in cases concerning personal welfare.