University Hospitals Bristol NHS Foundation Trust v ED [2020] EWCOP 18

​Application by a hospital Trust for declarations that it is lawful, if there is a deterioration in the condition of the P (a) not to provide CPR or any other resuscitative measure and (b) not to admit her to the ICU Unit or provide an ICU level of care, even if, absent this order, she would meet the criteria for ICU admission.

The P was born with quadriplegic Cerebral Palsy and she has severe learning difficulties. She has been admitted to hospital several times suffering from pneumonia and Type 2 respiratory failure. The reason for this hearing was to determine whether she should, in the future, be admitted to ICU or whether her care should take place on the Respiratory Ward. The Trust's position is that her state of health is precarious and unpredictable and the reasons that it advances for its application is to avoid the P from undergoing extensive and potentially invasive medical treatment that the Trust considers not to be in her best interests. It says they would have a low prospect of success and that, if successful, would likely lead to a worse quality of life. The P's mother opposed the application, disputing the decision the Trust wishes the court to take is in the P's best interests. She said she does not agree that the P lacks capacity.

First the court concluded that the P does lack capacity to conduct these proceedings and to make decisions about what medical treatment she receives. The court also ruled that if the P deteriorated again, the treatment that she should have, all other things being equal, is on the Respiratory Ward. It will be the best possible treatment on that ward. It will include ventilation, antibiotics and include physiotherapy but it will not include the extra active involvements of the ICU Unit. That in the court's view will not assist her, will harm her and cause her pain and is likely to be entirely futile.

Read the full text of the judgment on Bailii