NHS North Central London Integrated Care Board v XR and others (Withdrawal of Life Sustaining Treatment: Delay) [2024] EWCOP 66 (T3)

Best interests decision concerning the medical treatment of a 62 year old man in a prolonged disorder of consciousness who is being cared for at the Royal Hospital for Neuro-disability.

XR shows no awareness of his surroundings, he is unable to communicate and requires 24 hour care. The medical evidence is that his condition is permanent with no prospect of recovery. He has not been visited since 2018 and has no known family or friends who can provide details as to his wishes, feelings, values and beliefs. If care is continued then it was agreed XR could live for another few years but if treatment is withdrawn he would be expected to die within 21 days.

After reviewing the medical evidence and the legal framework the Deputy President, Theis J, concludes that "the benefits of such treatment continuing are significantly outweighed by the considerable burdens for XR caused by the daily care interventions". She then goes on in [69-94] to set out some guidance on this and other similar cases emerging from the RHN stating at [94] 

"The wholly unacceptable delays in GU, AB and now this case send out a blunt but clear message that such delays in effective best interest decision making are unacceptable and wholly contrary to the patient’s best interests which there is a clear statutory obligation on the responsible care providers to protect."

Read the judgment on the National Archive