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(Court of Protection, Hayden J, November 2013)
The72-year-old man suffered from a number of medical conditions including type II diabetes mellitus, he had suffered a stroke in 2000 and as a result experienced right-sided weakness, hypertension and chronic renal impairment. He was housebound and needed assistance with toileting and feeding but had received care and support from a loving family for the previous 10 years.
When he suffered a cardiac arrest, preceded by community-acquired pneumonia, his son was able to perform CPR and upon arrival at hospital he was resuscitated. However, 5 days later he remained in a coma with abnormal, extensive posturing on stimulation. Medical evidence demonstrated that the man had only a very limited prospect of recovery but it was highly unlikely he would make any meaningful recovery to his communicative and motor function. He would remain dependent on PEG feeding and occasional ventilation. The consensus amongst the medical experts was that intensive care interventions would be wholly contrary to the central medical objectives of intensive care
The NHS Foundation Trust applied for declarations that the man lacked capacity to consent to medical treatment (which was agreed between the parties); that it would be unlawful to provide intensive care in the event of a deterioration or collapse of the man's condition; that it would be unlawful to provide resuscitation following cardiac or respiratory arrest. The family strongly resisted the application largely on the basis of their firmly held Islamic faith.
Taking into account all of the circumstances of the case including the medical evidence and the strongly held views of the family, it was clear that to require the treating clinicians to treat the man in intensive care would be wholly futile as it would: be likely to cause, distress, discomfort and pain; be unable to achieve any positive medical benefit; be life threatening in and of itself; and, further compromise his vital organs and, therefore, be medically harmful.
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