​Northern Care Alliance NHS Foundation Trust v KT & Ors [2023] EWCOP 46

Application by the NHS Trust seeking a declaration that it is lawful for the P, who has been left with significant brain damage after a large left-parietal intracranial haemorrhage, to receive palliative care only. The application was allowed.

In February 2022, KT was undergoing dialysis for end-stage kidney failure when he suffered a large left-parietal intracranial haemorrhage. Despite undergoing emergency surgery, KT was left with significant brain damage. He has remained an inpatient at a specialist neurosurgical unit where he receives life-sustaining treatment, including haemodialysis and Clinically Assisted Nutrition and Hydration (CANH). KT is in a “prolonged disorder of consciousness”. The compelling medical consensus establishes that he has no awareness and no scope for rehabilitation. He may have vestigial capacity to experience discomfort and distress and, at least theoretically, some ability to be soothed by his environment which does not equate to awareness. As well as chronic Stage 5 kidney failure, KT also has co-morbidities, namely, Type 2 diabetes mellitus, diabetic retinopathy, and hypertension. His life expectancy is now very limited. The primary pathology is KT’s renal failure and he is dependent on haemodialysis three times a week to keep him alive. However, safely dialysing him has become increasingly challenging as his blood pressure tends to drop during dialysis, carrying a risk of yet further brain injury, cardiac arrest, or heart attack. The Trust sought a declaration that it is lawful to receive palliative care only. Should this course of action be followed, it is likely KT would die in consequence of renal failure within two weeks. KT's family disagreed and sought to persuade the court to compel the Trust to continue treatment.

The court concluded, after exploring all the available limited options, that continued treatment would require those caring for him to cause harm without delivering benefit. The court delayed the ending of treatment for 21 days to enable the family to make arrangements to say their goodbyes.

Read the full text of the judgment here.