Supreme Court reaches landmark decision on end-of-life care

The Supreme Court has ruled that families will no longer require legal permission to end care for loved-ones in a long-term, permanent vegetative stage.

This means that where relatives and medical professionals are in agreement, the withdrawal of food and drink can be undertaken without the need to first apply to the Court of Protection.

The ruling came about as a result of the Supreme Court quashing an appeal in respect of a case of a 52 year old man, who’s family had decided to withdraw treatment keeping him alive. Following a cardiac arrest last year, the man had suffered an extensive brain injury leaving him in a coma with no realistic prospect of ever regaining consciousness. His family and medical professionals agreed to withdraw food and in November last year, the High Court ruled they did not need to seek permission from the Court before doing so.

An appeal of the High Court’s decision was brought by the Official Solicitor, due to the significance of the issues which had arisen in respect of those who lack capacity and are unable to make decisions about their own treatment. The Supreme Court yesterday dismissed the appellant’s arguments. These suggested that withdrawal of treatment should be subject to an assessment about whether it is in the patient’s best interests and that all such cases should be brought to Court, regardless of whether there is agreement between the patient’s family and doctors.

In dismissing the appeal, Lady Black noted that whilst there would still be cases where an application to the Court would be necessary or desirable (e.g. where there are differences of opinion on the best course of care) she considered that where there is agreement between families and doctors, this was sufficient to ensure “public confidence” in the decisions being made.

For some this will be a controversial decision, with concerns that vulnerable patients unable to make their own decisions will have less protection. However, others view this decision as a long time coming and will allow those closest to the patient to make the best choice for them.

A solicitor in the Medical Negligence team at Ashtons comments: “The Supreme Court’s ruling is certainly a landmark decision and is likely to have significant impact on the scope of cases now being brought before the Court in respect of end of life care. Relatives will now have more autonomy to ensure they can make the best, and often very difficult, decision in respect of their loved one’s care. Importantly, however, it has also been recognised there still will be some examples where the Court’s input is needed to ensure the best outcome for vulnerable patients where a decision about their end of life care cannot be agreed.”