Hillingdon Hospitals NHS Foundation Trust v IN & Ors [2023] EWCOP 32

Judgment concerning whether to withdraw treatment for a patient described as being in a permanent coma

IN, a fifty five year old Romanian man, had suffered a severe stroke leading to a cardiac arrest and hypoxic brain injury. He has been in a coma for over six months and his brain showed signs of global atrophy. The applicant Trust says the coma is irreversible, with no prospect of recovery further and the burden of continuing CANH cannot be justified as being in IN’s best interests. They sought declarations and orders that it would be lawful to withdraw CANH and for IN to receive palliative care only.

In this judgment Poole J first directs himself to An NHS Trust v Y [2018] UKSC 46 which provides useful guidance on navigating such cases. He then reviews the medical evidence and the wishes of IN's family, who as Christians, wanted to give IN the chance of a recovery. At [35] he notes IN's own faith but goes on to say it is not obvious he would have decided against withdrawing the treatment had he retained capacity. He then concludes at [41] 

"that this is a case in which the presumption that life should be preserved is displaced by the weight of countervailing factors, most particularly the very profound brain damage which has left IN in a permanent coma from which he is highly unlikely to emerge even to a vegetative state, the inability to experience pleasure, the burdens of his condition and continued treatment and the absence of any prospect of improvement. I do not find it possible to ascertain IN’s own wishes and feelings. His values and beliefs may or may not have led him to decide to continue CANH had he retained capacity. The views of his family members about his best interests and his values and beliefs weigh in favour of continuing CANH, but not to the extent that they outweigh the other factors supporting the withdrawal of treatment."

He also makes some points about the transparency order around the proceedings, deciding that this is a case where the patient can remain anonymous.

Read the judgment on Bailii