When is it lawful to withhold medical treatment?
July 25, 2013
In cases where a person lacks legal capacity to make their own decisions about their medical treatment, such decisions should be made in that person’s best interests. This includes decisions about withholding or withdrawing treatment.
The basis on which these decisions should be taken, the interpretation of futility and the persons wishes and feelings, are some of the issues being considered by the Supreme Court in a groundbreaking case heard today.
Mrs Alice May James, a client of QualitySolicitors Jackson & Canter, is seeking to clarify an important question. When is it in a patient’s best interests to withhold medical treatment when he or she is critically ill, but who nevertheless has a measureable quality of life from which he or she gains pleasure? The patient in question was her husband of fifty years who sadly died at the end of last year. The hospital’s view was that further treatment was futile, but Mrs James and her children disagreed. Her husband, although ill, was to some extent conscious and the family believed he was still getting enjoyment from contact with his wife and close family.
The hospital sought a declaration from the Court that it was in Mr James’ best interests for further treatment to be withheld in the event of a clinical deterioration, on the basis that such treatment would be ‘futile’ and ‘overly burdensome’. The family argued strongly that treatment should be continued. The Court found for the family and refused to endorse the withholding of further treatment. This was quickly challenged in the Appeal Court where the Judges took an alternative view. Mr James sadly died shortly after the decision.
Mrs James continued to argue that this case is very different from other cases, such as the Bland case, where the patient was in a persistent vegetative state. Her husband, although ill, was still aware of their presence and able to communicate with his wife, for example by giving her a kiss. As such continuing treatment was not futile. She obtained permission to appeal to the highest court in the land for a ruling on this very important point of legal principle.
It is now for the Supreme Court to delve into the legal situation and provide guidance on how similar best interests decisions should be taken in the future. The judgment is not expected for some time. However, when it is delivered, each one of us has the potential to be deeply affected by the outcome of this important case.
Susan Flynn and Corine Hims from our Church Street office have handled the case and Ian Wise QC and Stephen Broach from Doughty Street Chambers represented Mrs James in the court process.