Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust v TG & Anor [2019] EWCOP 21

This was a judgment concerning a patient in the critical care unit of the Royal Bournemouth Hospital and whether or not it was in the best interests of that patient that intubation should continue or not continue to be provided.

The patient concerned had been attending church in December 2018 when she had collapsed and suffered a subarachnoid haemorrhage and secondary cardiac arrest.  The seriousness of her collapse was not at first fully appreciated and thus resuscitation attempts were delayed. Following her admission to Royal Bournemouth Hospital scans showed extensive damage to the patient’s brain.

The medical evidence presented and agreed between the experts indicated the best outcome of any recovery would be to a minimally conscious state (MCS minus) in which the patient would only be able to have awareness of pain but nothing more than minimal consciousness at a very low level.  In light of the evidence the health Trust were of the opinion that there was no benefit in the continuation of treatment except for the fact the patient would remain alive.

In making his judgment Cohen J referred to the fundamental principle of the sanctity of life and stated that the best interests test must be applied, which is widely defined as going far beyond simply clinical best interests.  Consideration was given to Briggs (no 2) [2017] 4WLR 37 and Lambert v France [2000] 30 EHRR in which the wishes and feelings of the patient were central to the decision.

Consideration was given to the evidence filed on behalf of the patient’s family and friends and what this revealed about her wishes, feelings, beliefs and values.  The evidence portrayed that the patient had been a devout Catholic who believed in the sanctity of life and discussions undertaken before her collapse revealed that she would never accept anyone else facilitating her death.

Cohen J additionally noted that the Royal College of Physician guidelines state 6 months are required to pass before a vegetative state can be regarded as permanent and only two months had elapsed in this case.  In light of these factors, Cohen J came to the clear decision that it was in the patient’s best interests that intubation should continue and the application was refused.

The full judgment can be read here.

If you have any questions regarding this summary case law please contact Michelle here.

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