Key Facts
- •KT, a 53-year-old man, suffered significant brain damage after a haemorrhage, leaving him in a prolonged disorder of consciousness with no awareness and no scope for rehabilitation.
- •He has end-stage kidney failure requiring haemodialysis, which has become increasingly risky.
- •KT's family, devout Pentecostal Christians, oppose the withdrawal of life-sustaining treatment, believing in the power of prayer and miracles.
- •The Northern Care Alliance NHS Foundation Trust applied for a declaration that it is lawful to provide only palliative care.
- •KT lacks capacity to make decisions about his medical treatment.
Legal Principles
Best interests determination under the Mental Capacity Act 2005 (MCA)
Mental Capacity Act 2005, Section 4
MCA Code of Practice guidance on life-sustaining treatment
MCA Code of Practice, paragraphs 5.31-5.33
Best interests test considering patient's welfare in the widest sense (medical, social, psychological), treatment prospects, likely outcome, patient's attitude (or likely attitude), and views of carers/interested parties
Aintree University Hospital NHS Foundation Trust v James [2013] UKSC 67, paragraphs 39, 45
Presumption in favour of prolonging life, aligning with the spirit of the European Convention on Human Rights (ECHR)
Burke v UK [2006] ECHR 1212
Focus on whether treatment is in the patient's best interests, not on whether withdrawal is in best interests
Aintree University Hospital NHS Foundation Trust v James [2013] UKSC 67, paragraph 22
Recognition of the value of human life and respect in which it must be held
An NHS Trust v Y [2018] UKSC 46, paragraph 92
Wishes and feelings are a significant factor but not determinative in best interests decisions; weight varies case-by-case
Re M (Statutory Will) [2009] EWHC 2525 (Fam), Re G (TJ) [2010] EWHC 3005 (COP), IIBCC v LG [2010] EWHC 1527 (Fam), Wye Valley [2015] EWCOP 60, Briggs (No. 2), Salford Royal NHS Foundation Trust v P [2017] EWCOP
Outcomes
The application by the Trust to provide only palliative care was granted.
Continuing life-sustaining treatment was deemed futile, burdensome, and risky, potentially causing further harm and suffering to KT. While the court acknowledged and respected the family's strong religious beliefs and KT's likely wish to continue treatment, it ultimately concluded that this was not in his best interests.