Leeds Teaching Hospitals NHS Trust v JF (By her Litigation Friend, the Official Solicitor) and CH [2018] EWCOP 32

This case concerned the ongoing treatment of JF (“N”) following a sad series of health issues she suffered arising from her lengthy battle with breast cancer, which had become terminal, and a sudden cardiac arrest on 26 May 2018, which left her in an unconscious state.

The Trust sought to discontinue treatment by removing N’s endotracheal tube and by not administering any treatment that would extend her life; acknowledging that to do so would be likely to expedite her passing away in advance of her otherwise anticipated death from cancer. The Trust also wanted to be able to administer morphine in the event it should be required.

N’s family wanted the Trust to replace the existing endotracheal tube (which would need to be replaced if treatment was to continue), on the basis that to remove the tube would hasten her death against N’s wish to have a “natural death”. They also wanted the Trust to administer treatment by way of antibiotics only in the event that N was to contract an infection. They also wanted the court to uphold N’s and their objection to the use of morphine in favour of alternative pain relieving medications.

Mr Justice Cohen summarised the legal principles which apply in cases of this nature, including the relevant sections of the Mental Capacity Act, particularly Section 4(6) and the test to be applied when determining a course of action that is in a best person’s interests namely (a) N’s past and present wishes and feelings; (b) the beliefs and values that would be likely to influence her decisions if she did have capacity; and (c) other factors that she would be likely to consider if she was able to do so.

The Judge concluded that: (a) N’s endotracheal tube should remain in place on the basis that “it would need a very good reason to hasten [N’s death] in this way”; (b) that any death arising from N contracting an infection which was left untreated would amount to a “natural death” and, accordingly that no antibiotics or life extending treatment should be administered; and (c) that the Trust should have permission to administer any pain medication except for morphine, but gave the Trust permission to apply to the court in respect of morphine should N’s pain level increase.

The full judgment can be read here.

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