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Court approves withdrawal of treatment in landmark end-of-life case

Date:20 NOV 2015

Court of Protection rules life-sustaining treatment can be stopped for patient in 'minimally conscious state

The Court of Protection yesterday (19 November 2015) authorised the withdrawal of treatment from a 68-year-old woman who is at the end stages of multiple sclerosis - the first time such a decision has been made to withdraw life-sustaining treatment from a person in a 'minimally conscious state'.

A judge was asked to decide whether doctors could stop providing treatment by the woman's daughter and and family who say that the treatment is prolonging an existence without dignity or quality of life.

The woman, who is being treated in the North of England but cannot be identified for legal reasons, was diagnosed with multiple sclerosis in 1991, and for around the past 8 years has been provided with nutrition, fluids and medication through a tube.

At the Court of Protection, Mr Justice Hayden ruled that treatment could now be stopped after hearing evidence from medical experts as well as the family of the woman.

Matheiu Culverhouse, a specialist Court of Protection lawyer at Irwin Mitchell representing the woman's daughter, said:

'There are no winners or losers in sensitive and emotional cases like this.

'The situation is distressing for all of those involved but, after hearing evidence from the family, carers and medical experts presented to the court, the judge decided that withdrawing the life-sustaining treatment is in the woman's best interests given her current quality of life.

'While this is clearly distressing for her daughter, she is relieved that the court has been able to review and examine the expert medical evidence available and hear detailed legal arguments before making a decision which will now end her mother';s suffering and indignity.

'This landmark decision is the first time the Court of Protection has agreed to withdraw treatment from someone receiving life-sustaining treatment while considered by medical experts to be in a 'minimally conscious state'. However, all cases of this kind are decided on their own facts, and judges will always examine all the evidence presented to them, including that presented by the patient's family affected, on an individual basis.'

The woman's interests were represented by the Office of the Official Solicitor, which acts for people without mental capacity to make decisions themselves. The Official Solicitor indicated during the course of the hearing that he supported the application to withdraw life-sustaining treatment, meaning that by the end of the case the application was not opposed by any of the parties involved.

The woman's daughter told the court that continuing treatment at this stage would be against her mother's wishes. She said:

'My mum's immaculate appearance, the importance she placed on maintaining her dignity and how she lived her life to its fullest is what formed her belief system, it's what she lived for.

'All of that is gone now, and, very sadly, my mum has suffered profound humiliations and indignity for so many years.

'I cannot emphasise enough how much the indignity of her current existence is the greatest contradiction to how she thrived on life and, had she been able to express this, then without a doubt she would.'

Arrangements will now be made for treatment to be withdrawn in line with national clinical guidelines. The family ask that their privacy is respected at this difficult time.