On the face of it, the decision by a High Court judge in the case of M is no surprise - few would have expected a ruling to allow a patient with any level of consciousness and feeling to die. But a closer inspection of the 76-page judgement shows that Mr Justice Baker did not find his decision a straightforward one.
The husband of a woman who died in one of Britain's best-known hospitals is taking its management and the health secretary Andrew Lansley to court, alleging an illegal use of "do not resuscitate" orders. David Tracey claims doctors at Addenbrooke's hospital, Cambridge, twice put such orders in his wife's medical notes, cancelling the first after she objected to it only to put in a second three days later without her consent or any discussion with her. Tracey alleges the hospital's actions deprived his 63-year-old wife Janet of the right to life and subjected her to degrading treatment, while he was denied respect for his personal and family life. He is also seeking to force the coalition government to draw up a policy for England on the use of Do Not Attempt Cardio-pulmonary Resuscitation (DNACPR) instructions, and claims the present system of local policies is open to abuse.
A doctor has agreed a baby in a "right-to-life" legal row may be able to interact - but any mental development would only make his fate more tragic. The paediatric neurologist told the High Court the severely disabled child, Baby RB, would remain in a "no chance" situation even if he developed further. He questioned the life the boy would lead if he was capable of cognitive function but physically so disabled.
Although DJ's condition is in many respects grim, I am not persuaded that treatment would be futile or overly burdensome, or that there is no prospect of recovery. (a) In DJ's case, the treatments in question cannot be said to be futile, based upon the evidence of their effect so far. (b) Nor can they be said to be futile in the sense that they could only return DJ to a quality of life that is not worth living. (c) Although the burdens of treatment are very great indeed, they have to be weighed against the benefits of a continued existence. (d) Nor can it be said that there is no prospect of recovery: recovery does not mean a return to full health, but the resumption of a quality of life that DJ would regard as worthwhile. The references, noted above, to a cure or a return to the former pleasures of life set the standard unduly high.
The family of a man left in a vegetative state after a heart attack has made an eleventh hour appeal for doctors to do all they can to keep him alive as they await a vital court ruling. Tomorrow, the court of protection in London will be asked to rule in a dispute over whether it is in "the best interests" of the severely brain-damaged man, who is from the Greater Manchester area, to continue to receive life-saving treatment if his condition deteriorates. Pennine Acute Hospitals NHS Trust claim it is not in the best interests to offer the man, known only as L, ventilation or resuscitation if his condition worsens and he suffers "a life-threatening event", such as another heart attack. But his family disagree and say they, not the trust, must be given the right to decide on his care.
When they told my father-in-law the hospital had done all it could, that was not, in the strictest sense, true. There was nothing the doctors could do about the large, inoperable tumor colonizing his insides. But they could have maintained his failing kidneys by putting him on dialysis. They could have continued pumping insulin to control his diabetes. He wore a pacemaker that kept his heart beating regardless of what else was happening to him, so with aggressive treatment they could — and many hospitals would — have sustained a kind of life for a while. But the hospital that treated him offers a protocol called the Liverpool Care Pathway for the Dying Patient, which was conceived in the 90s at a Liverpool cancer facility as a more humane alternative to the frantic end-of-life assault of desperate measures.
A hospital trust can withhold life-saving treatment from a severely brain-damaged Muslim man if his condition deteriorates, a court has ruled. Doctors argued it would be unfair to resuscitate the patient, known as Mr L, if his condition worsened. His family, of Greater Manchester, said that was against their Muslim faith. At the Court of Protection, Mr Justice Moylan said it would be lawful to withhold treatment as it would not prolong life "in any meaningful way". He added: "It would result in death being characterised by a series of harmful interventions without any realistic prospect of such treatment producing any benefit."
This application concerns AW, a 57-year-old woman who is in a permanent vegetative state. It is made by the NHS Trust responsible for her care, which seeks a declaration that it is lawful and in her best interests to withdraw active medical treatment, including specifically artificial nutrition and hydration, albeit that this will lead to AW's death. The application is supported by AW's family, by all the medical staff who look after her, by the evidence of the expert witnesses who have reported, and by the Official Solicitor on behalf of AW herself.
Comprehensive guidance for doctors on care at the end of life, including difficult decisions on when to provide, withhold, or withdraw life prolonging treatment, will go out for consultation from the UK’s General Medical Council in March. The draft guidance was approved by the council at its February meeting, subject to minor amendments. The consultation will be launched in the week beginning 23 March and will end in July. The new advice takes account of the Mental Capacity Act 2005; government strategies on end of life care in England and Scotland; GMC guidance in 2007 on consent; recent research; and a Court of Appeal judgment on a legal challenge to the GMC’s 2002 guidance Withholding and Withdrawing Life-Prolonging Treatments (Burke).
When faced with a terminal illness, medical professionals, who know the limits of modern medicine, often opt out of life-prolonging treatment. An American doctor explains why the best death can be the least medicated – and the art of dying peacefully, at home