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(Family Division, Theis J, 1 May 2012)
The man suffered from Amyotrophic Lateral Sclerosis: Motor Neurone Disease, since he was 57. For the previous 8 years he was assisted by an invasive ventilation device. He was able to communicate using a communication board and latterly through eye movements. Despite his care needs he had been cared for at home assisted by carers from an independent care agency and his wife.
At various times the man had indicated his wish to have life-sustaining treatment withdrawn but had not done so in a consistent form. He then decided to execute an advance direction that he wished to withdraw his consent to treatment if his disease progressed to the stage where he could no longer communicate and lost the ability to control his decisions of care and management. It was agreed by the GP, mental capacity co-ordinator and the man's wife.
On the evidence it was clear the man had capacity to make the advance direction and that it complied with all the necessary formalities. Despite the fact that the document had a review date, it was not the man's intention that the direction should become ineffective at some point in the future and that date merely ensured that it was kept under review.