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06 FEB 2013

WITHDRAWAL OF MEDICAL TREATMENT: The NHS Trust v AW (By Her Litigation Friend The Official Solicitor) [2013] EWHC 78 (COP)

(Court of Protection, Peter Jackson J, 23 January 2013)

The 57-year-old woman was in a permanent vegetative state. The NHS Trust responsible for her care sought a declaration that it was lawful and in her best interests to withdraw active medical treatment including specifically artificial nutrition and hydration, albeit that that would lead to her death. The application was supported by the woman's family, all of the medical staff who cared for her, by the evidence of expert witnesses and the Official Solicitor on her behalf.

The woman had led an active and full life until she suffered a subarachnoid haemorrhage 20 years ago which restricted some of her activities but she generally continued to be active. Then 4 years ago she suffered a spontaneous severe intra-cerebral haemorrhage from which she never recovered and necessitated her admittance to intensive care. She has since remained in a vegetative state and was cared for at a specialist nursing home.

The woman had previously expressed her view to her family that she thought it preferable to die quickly rather than experiencing a long-term illness and suffering.

Two experts were of the opinion that the woman was in a permanent vegetative state and a recent SMART assessment found no meaningful or purposive behaviour.

The court found that the woman was in a permanent vegetative state from which there would be no change and the treatment regime was futile. The court made declarations that the woman lacked capacity to litigate or to make decisions about medical treatment; that it was lawful and in the woman's best interests for life-sustaining treatment in the form of artificial hydration and nutrition to be withdrawn.


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