Northumbria Healthcare NHS Foundation Trust v HX & Ors
[2024] EWCOP 52 (T3)
AA (Withdrawal of Life-Sustaining Treatment: No Best Interests Decision), Re
29 July 2024
[2024] EWCOP 39 (T3)
Court of Protection
A seriously ill man's family disagreed with doctors' plan to end life support. Because there were no other options, and the doctors would proceed anyway, the judge didn't make a decision on the treatment plan but confirmed the man lacked capacity to decide for himself. The judge also dismissed the application to make a legal declaration that would protect the doctors.
Key Facts
- •AA, a 33-year-old with multiple health issues, suffered a major haemorrhage and cardiac arrest, resulting in significant brain injury.
- •AA is in a prolonged disorder of consciousness, bordering on a vegetative state, with no prospect of recovery.
- •Clinicians recommended withdrawing clinically assisted nutrition and hydration (CANH) and initiating palliative care, including morphine and midazolam.
- •AA's parents strongly opposed the withdrawal of CANH and palliative care, disputing the prognosis and diagnosis.
- •Nursing homes refused to admit AA due to his deteriorating condition and the parents' objections.
- •The ICB applied to the Court of Protection for authorization, later shifting to seeking a declaration of lawfulness under the inherent jurisdiction of the High Court.
Legal Principles
A patient cannot require a doctor to give any particular form of treatment, nor can a court.
NHS Trust v Y [2018] UKSC 46
It is an abuse of process to use a best interests declaration under the MCA 2005 to persuade a clinician to provide treatment where none is offered.
AVS v A NHS Foundation Trust & Anor [2011] EWCA Civ 7
The court must consider all relevant circumstances when exercising powers under the Mental Capacity Act 2005.
MCA 2005 s.1(5) and s.4
If there are no treatment options, the court has no effective choice to make.
An NHS Trust v L & Others [2012] EWHC 4313 (Fam)
Clinicians are not legally obliged to seek a court declaration on the lawfulness of proposed treatment.
Re Y [2018] UKSC 46 at paragraphs 29-33
Outcomes
Declaration of incapacity made.
Overwhelming evidence established AA lacked capacity.
Declaration under the inherent jurisdiction declined.
The declaration would not affect the outcome, as clinicians would proceed with the palliative care plan regardless. It was deemed purposeless and primarily for the protection of clinicians from potential legal action.
Application for a personal welfare order dismissed.
No alternative treatment options existed, rendering further court involvement pointless.