Barnsley Hospital NHS Foundation Trust v MSP [2020] EWCOP 26

Application by the Trust to withdraw artificial nutrition and hydration from the P who had expressed, in an advance decision, that he did not want to live with an irreversible stoma. The application was granted.

The application related to the P, a 34-year-old man with a complicated abdominal history which has caused him to have significant gastrointestinal problems for approximately 10 years. The issue framed in the application is whether the Trust should continue to provide ITU support or withdraw treatment other than palliative care. The P had had a stoma inserted in May 2020, with his permission, when he was in a life threatening situation. However, in an advance decision made in February 2020, the P made it clear that he did not want to live if 'treatment that, while potentially necessary for sustaining or prolonging life, would result directly or indirectly information of a stoma ... that is expected to be permanent or with likelihood of reversal of 50% or under.'

The court granted the application. In the exercise of his personal autonomy the P was entitled to take that decision which the court was required to and did respect. Accordingly, the plan advanced by the Trust was in the P's best interests. The court said:

"In a real sense this is not a case about choosing to die, it is about an adult's capacity to shape and control the end of his life. This is an important facet of personal autonomy which requires to be guarded every bit as jealously for the incapacitous as for the capacitous."

Read the full text of the judgment on Bailii