​PL v Sutton Clinical Commissioning Group & Anor [2017] EWCOP 22

​The Patient's son (with the support of the rest of the family) was seeking a declaration that it was not in his mother’s best interests that CANH should be continued, with the inevitable and foreseeable consequence that she would shortly thereafter die. The court concluded that it was not in her best interests; it followed that the discontinuance of the CANH treatment was therefore lawful.

A little over a year ago the Patient suffered a catastrophic stroke which has left her very severely physically disabled, brain damaged, and significantly incapacitated. Although she was receiving good quality nursing care round the clock in a residential home, she was being kept alive only through the provision of Clinically Assisted Nutrition and Hydration (‘CANH’) through a Percutaneous Endoscopic Gastrostomy (‘PEG’) tube. She did not make any formal advance decision to reflect her wishes and feelings about life-sustaining treatment but the views which she had expressed to her family and friends about the prospects of being dependent on life support, or receiving artificial assistance in order to survive were clear: she simply would not want this.

The court ruled that it was not in her best interests for CANH to be continued; it followed that the discontinuance of the CANH treatment was therefore lawful. 

Editors comment
No one in this case were against the cessation of CANH or feeding via a PEG tube. Although the CCG was neutral on the application they did not oppose it.

This case is useful to practitioners as it reviews the relevant legislation including the rules and the authorities as well as the code of practice and led to a reserved judgment which concluded that it was not unlawful to discontinue the CANH.

What may surprise, and sadden, many is that this was an application launched on 24 April 2017, judgment given by the court on 11 September 2017 after two days of earlier hearing, CANH was withdrawn on 29 September and PL died on 9 October.

Can it be little wonder that the clear steer now provided by the courts in these tremendously sad cases is that where there is unanimity of view as to outcome from treating clinicians, family members and other interested parties then there is no necessity to have to be burdened emotionally and financially by the lengthy court process in order for that decision to be ratified.

Read the full text of the judgment on Bailii