NHS North West London Integrated Care Board v Z & Anor [2024] EWCOP 35

Application to withdraw clinically assisted nutrition and hydration from Z, a 70 year old man who had suffered a major haemorrhage after surgery in 2021 which led to a Prolonged Disorder of Consciousness.

Z had been in good health before the surgery and was now being well cared for in a nursing home. His wife, who visits daily, had seen signs of physical activity such as yawning, grimaces to sound and tears but  Dr H, a Consultant in Neurorehabilitation Medicine, described them as "rudimentary neurological phenomena denoting varying arousal, arising from the devastating destruction of all awareness networks, with some preserved arousal." Meetings between the family and the medical team came to no agreement so the ICB applied to the court.

The Vice-President, Theis J, reviews the medical evidence and at [5] recounts her own visit to see Z before noting at [63] that the "sad and tragic reality of this case is Z has no prospect of recovery due to the severity of the brain injury he suffered". At [71] she sets her reasons for concluding that CANH can be discontinued. She also notes at [70] the comment of counsel for the OS that "when the time comes for us all everyone would want what W says Z would want; a quick and dignified death. That is not an option in this case."

Read the judgment on the National Archive