Imperial College Healthcare NHS Trust Applicant and C & Ors [2022] EWCOP 28

Judgment concerning medical treatment for C, who was on a ventilator following a cardiac arrest, involving consideration of the religious background of C and her family.

C’s health, who in earlier years had been a dynamic mother, campaigner and pillar of the local church, had declined and in early 2022 she entered hospital following a fall at home. She was found to have kidney problems and raised heart rate. A week later she suffered a cardiac arrest and spontaneous circulation was only achieved after 20-25 minutes leaving her in a vegetative state. The ICU team decided that it was in C’s best interests to provide palliative care and wean her off the ventilator.
In this judgment Hayden J, the Vice-President, had to decide on C’s best interests against a background of the family’s devotion and religious belief that their mother would want to fight to remain alive. At [25] he sums up the position:

“I am very clear that Mrs C would think it her duty to fight for as long and as hard as possible, to hold on to a life that she regards as a gift from God. She would, as the family conveyed to me, wish to put her life in God’s hands. All this said, the battle that she contemplates must be time limited. Dr Danbury thought it should be a maximum of 14 days. Any longer would be unethical. All, including the family, accept this. 14 days is a very long time to struggle to breathe.”

After then reviewing the legal framework, he approves the Trust’s plan to wean C off the ventilator, though noting that it had a very small chance of success and at [33] concludes

“It is clear that the family hope that their mother will recover to an extent that restores something of her vitality and enthusiasm. That hope, simply cannot be supported by the evidence. Should the weaning be successful, Mrs C’s neurological damage will continue to compromise her level of awareness and ability to experience life around her. I am however, entirely satisfied, that Mrs C would “be up for the fight”, as the family have termed it. It is not for me to stand in her way.”