NR (A Child: Withdrawal of Life Sustaining Treatment), Re
[2024] EWHC 910 (Fam)
A Hospital Trust v P & Ors
15 February 2024
[2024] EWHC 313 (Fam)
High Court
A little girl was very sick and wouldn't get better. Doctors said keeping her alive on machines was causing her pain and wasn't helping. Even though her parents were very sad, they agreed with the doctors. The judge decided it was best to let the girl pass peacefully, with her family.
Key Facts
- •Two-year-old P suffered a devastating, irreversible brain injury following a cardiac arrest.
- •P is in a vegetative state, requiring life support and experiencing likely pain.
- •Medical professionals unanimously agree that continued life-sustaining treatment is not in P's best interests.
- •P's parents, though distressed, left the decision to the court, acknowledging the medical evidence.
- •The court considered P's best interests holistically, including medical, emotional, and religious factors.
- •P's mother is a prisoner on remand.
- •P's father is profoundly deaf and non-verbal.
Legal Principles
Paramount consideration is the child's best interests; court exercises independent judgment.
Manchester University NHS Foundation Trust v Fixsler [2021] EWHC 1426 (Fam) at paragraph 57
Best interests considered broadly, including medical, emotional, sensory, and instinctive factors.
Manchester University NHS Foundation Trust v Fixsler [2021] EWHC 1426 (Fam) at paragraph 57
Strong presumption in favor of preserving life, but rebuttable if suffering outweighs benefits.
Manchester University NHS Foundation Trust v Fixsler [2021] EWHC 1426 (Fam) at paragraph 57
Court considers medical treatment's nature, prospects, and likely outcome.
Manchester University NHS Foundation Trust v Fixsler [2021] EWHC 1426 (Fam) at paragraph 57
Focus on whether treatment is in best interests, not withholding/withdrawing it.
Aintree University Hospital NHS Foundation Trust v James [2013] UKSC 67
'Best interests' includes wider welfare considerations (medical, social, psychological).
Aintree University Hospital NHS Foundation Trust v James [2013] UKSC 67
Convention rights (Article 2, 8, 9) considered through prism of child's best interests.
Outcomes
Granted the hospital trust's application to withdraw life-sustaining treatment.
Continued treatment offered no benefit and caused likely pain and suffering, outweighing the presumption in favor of preserving life. The holistic assessment of P's best interests, including medical evidence and the parents' views, led to this conclusion.