King’s College Hospital NHS Foundation Trust v XY & Anor
[2024] EWCOP 68
GUP v EUP & Anor
25 January 2024
[2024] EWCOP 3
Court of Protection
A seriously ill woman couldn't decide about her medical care. Doctors agreed that keeping her alive artificially wasn't in her best interests, as it wouldn't help her get better and might cause her pain. A judge agreed with the doctors and said it was okay to stop the artificial life support, focusing instead on keeping her comfortable.
Key Facts
- •EUP, a woman in her late eighties, suffered a series of strokes resulting in severe neurological impairment and loss of capacity.
- •The application concerned whether to continue life-sustaining treatment, specifically artificial nutrition and hydration.
- •EUP's family, particularly her youngest son GUP, initially hoped for recovery and opposed cessation of treatment.
- •Medical professionals unanimously agreed that continued artificial nutrition and hydration were not in EUP's best interests due to lack of benefit and potential for harm.
- •The case involved balancing the presumption in favour of life-sustaining treatment with the need to prioritize EUP's comfort and dignity.
Legal Principles
Best interests determination for incapacitated individuals must consider all relevant circumstances, including past and present wishes, beliefs, and values.
Mental Capacity Act 2005, s.4(6)
A strong presumption exists in favour of life-sustaining treatment, but it is not absolute; treatment may be lawfully withheld or withdrawn if it is not in the patient's best interests.
Aintree University Hospitals NHS Foundation Trust v James [2013] UKSC 67
Doctors are not legally obliged to provide treatment deemed not clinically indicated, even if the patient desires it.
Burke v General Medical Council [2005] EWCA Civ 1003
The court's role is to determine whether treatment is in the patient's best interests, not whether it is in their best interests to withhold or withdraw it.
Aintree University Hospitals NHS Foundation Trust v James [2013] UKSC 67
Outcomes
The court declared that providing life-sustaining treatment (including artificial nutrition and hydration), antibiotics, or CPR was not in EUP's best interests.
Continued treatment was deemed futile, burdensome, and potentially harmful, offering no prospect of meaningful recovery and causing distress.
The court approved the provision of palliative care focused on comfort and dignity.
This approach was deemed to be in EUP's best interests, aligning with medical consensus and promoting her well-being in her final stages of life.