Judge says medics can withdraw artificial feeding from woman in vegetative state

A judge in the specialist Court of Protection has ruled, without analysing evidence at a hearing, that a woman in a permanent vegetative state should be allowed to die.

Mr Justice Williams decided that medics can withdraw feeding by artificial means after privately analysing written submissions from lawyers representing a health authority and the patient.

His decision has emerged in a ruling published on a legal website.

Court of Protection judges consider issues relating to people thought to lack the mental capacity to make decisions for themselves.

Normally decisions relating to serious medical treatment are made at public hearings and media organisations are given a chance to make arguments about the identification of parties involved.

But Mr Justice Williams said in his ruling that Court of Protection rules allow judges to deal with an application without a hearing.

He said everyone involved, including family members, agreed that ending artificial feeding was in the woman’s best interests.

The judge, who is based in the Family Division of the High Court in London, said the woman’s relatives had been “content” for the application to be “made on paper”.

He said the woman, who was in her 50s, could not be identified but that the NHS Windsor and Maidenhead Clinical Commissioning Group had asked him to rule that artificial feeding could stop.

Mr Justice Williams said the woman suffered a cardiac arrest nearly four years ago and had never regained consciousness. She has been fed by artificial means since then.

The judge said she was diagnosed as being in a permanent vegetative state in 2015.

“Windsor and Maidenhead Clinical Commissioning Group have applied to the court for a personal welfare order,” he said in his ruling, which has been published on the British and Irish Legal Information Institute website.

“The order sought is for a declaration and order that it is not in (the woman’s) best interests for clinically assisted nutrition and hydration to be continued.

“In tandem with the withdrawal of clinically assisted nutrition and hydration, palliative care will be provided.

“The consequence is an expectation that (the woman) will die within seven to 14 days.”

He added: “Her family, who love her dearly, continue to visit her and to care for her. They all have reached the view that it is in her best interests

now that clinically assisted nutrition and hydration be withdrawn. They accept the inevitable outcome of that decision.”

Mr Justice Williams said the woman’s interests had been represented by staff at the office of the Official Solicitor, who help vulnerable people involved in litigation.

“I am satisfied that I can determine this case justly and in particular ensuring that (the woman’s) interests and position are properly protected without a hearing,” said the judge.

“Here, I am satisfied that the court had all the essential information and that further inquiries would not alter the fundamentals and would only lead to further delay.”

The judge said evidence showed that it would not be in the woman’s best interests for her life to be “artificially continued”.

“I accept the evidence of the family and the clinicians,” he said.

“They have reached their positions after the most careful thought, placing (the woman) at the centre of their concern, putting aside their own personal interests and concluding that she would not have wanted to go on living as she is.”

He said “ultimately” the decision was his and added: “With inevitable regret but being clear that this in (the woman’s) best interests, I therefore conclude that clinically assisted nutrition and hydration should be discontinued and replaced by palliative care.”

The judge did not say whether the woman was still alive.

Copyright (c) Press Association Ltd. 2018, All Rights Reserved. Picture (c) Kate Collins / PA Wire.