Key Facts
- •XY, a 54-year-old woman, suffered a catastrophic cardiac arrest resulting in severe hypoxic brain damage.
- •She has been in a prolonged disorder of consciousness for over six months.
- •King's College Hospital applied for declarations that XY lacks capacity and that withdrawing life-sustaining treatment is in her best interests.
- •XY's daughter opposes the application, supported by family and friends who believe XY is showing signs of improvement.
- •Medical experts unanimously agree that XY has suffered irreversible brain damage with no prospect of recovery.
- •The family observes what they believe to be signs of responsiveness, which the medical experts attribute to brainstem reflexes.
Legal Principles
Best interests determination under the Mental Capacity Act 2005.
Mental Capacity Act 2005, sections 4 and 15(1)(c)
Withdrawal of life-sustaining treatment; considering patient's welfare in the widest sense (medical, social, psychological).
Aintree University Hospital NHS Foundation Trust v James [2013] UKSC 67
Guidance on withdrawing life-sustaining treatment in adult patients.
PL v Sutton CCH and others [2017] EWCOP 22
Strong presumption in favour of preserving life; this can be rebutted by evidence that continued treatment is contrary to best interests.
Aintree University Hospital NHS Foundation Trust v James [2013] UKSC 67
Outcomes
The court granted the application.
The court found that continuing life-sustaining treatment was futile and not in XY's best interests, given the irreversible brain damage and lack of any prospect of recovery. The family's hopes for a miracle were weighed against the overwhelming medical evidence.