King’s College Hospital NHS Foundation Trust v XY & Anor
[2024] EWCOP 68
Whittington Health NHS Trust v XY & Ors
22 July 2024
[2024] EWCOP 37 (T3)
Court of Protection
A man was severely brain-damaged and unconscious. Doctors said keeping him alive was pointless and caused suffering. His family, deeply religious, wanted to keep him alive. The judge understood the family's feelings but agreed with the doctors. The judge decided it was wrong to continue treatment that only prolonged suffering and was not in the man's best interests.
Key Facts
- •XY, a 66-year-old man, is in a prolonged disorder of consciousness (PDOC) following a cardiac arrest and subsequent multi-organ failure.
- •Medical experts unanimously agree that continued ventilation and clinically assisted nutrition and hydration (CANH) are no longer in XY's best interests.
- •XY's family believes he has a greater level of awareness than the medical evidence suggests and that Allah can perform miracles.
- •The family's faith influences their desire to continue life-sustaining treatment.
- •Medical evidence indicates irreversible brain damage and a low probability of pain perception.
- •The family's interpretation of XY's responses is based on reflex reactions, rather than neurological functioning.
- •A recent EEG confirms widespread cortical dysfunction and a poor prognosis.
Legal Principles
Best interests determination under the Mental Capacity Act 2005 (MCA)
Mental Capacity Act 2005, Section 4
The 'best interests' test considers medical, social, and psychological welfare; the nature, prospects, and likely outcome of treatment; the patient's likely attitude towards treatment; and the views of carers and interested parties.
Aintree University Hospital NHS Foundation Trust v James [2013] UKSC 67
The court must not be motivated by a desire to bring about death when considering life-sustaining treatment.
MCA 2005, Section 4(5)
The presumption of domestic law is strongly in favour of prolonging life where possible.
Burke v UK [2006] ECHR 1212
Human rights, particularly Articles 2, 3, and 8 of the European Convention on Human Rights, are relevant.
European Convention on Human Rights, Articles 2, 3, 8
Outcomes
The court granted the declarations sought by the Trust, concluding that continued ventilation and CANH are not in XY's best interests.
The unanimous medical opinion, the lack of neurological improvement, the irreversible brain damage, the futility of continued treatment, and the absence of any benefit outweigh the family's wishes, although their sincerity and the strength of their faith were fully acknowledged.