A two day hearing at the Supreme Court starts today to look at whether decisions to withdraw CANH should have to be referred to a court, where medical experts and family agree with that course of action. 

The appeal has been brought by the Official Solicitor against the High Court decision in NHS Trust v Y & Anor [2017] EWHC 2866 (QB) where Mrs Justice O'Farrell granted a declaration to that effect, though in narrower terms than those sought.

The question before the Supreme Court is whether it is 

"mandatory to bring before the court the withdrawal of Clinically Assisted Nutrition and Hydration ("CANH") from a patient who has a prolonged disorder of consciousness ("PDOC"), in circumstances where the clinical team and the family are agreed that it is not in the patient's best interests that he continues to receive that treatment?"​

The facts of the case behind the appeal can be read on the Supreme Court website and the proceedings will be broadcast live on the same website here.

The Patient was in a minimally conscious state following a road accident in 2015. He was being kept alive by clinically assisted nutrition and hydration (CANH). He had not made an advance decision nor was there a power of attorney in place. His family wanted him to move to a hospice where he would receive palliative care, his CANH treatment would not be continued and as a result he would die. Mr Justice Charles ruled that it was not in the Patient's best interests for the court to give consent to his life sustaining treatment by CANH and that therefore it would be lawful for the clinical practitioners to withold or withdraw it.

Read the full text of the judgment on Bailii

Also read the related judgment where Mr Justice Charles ruled that applications relating to CANH can be brought under s21 MCA and thus the Patient's wife was eligible for non means tested funding through legal aid.

After concluding that the Patient was in a Persistent Vegetative State, the court made declarations that  it was no longer in her best interests to continue to receive artificial nutrition and hydration, and that it was lawful and in her best interests for artificial nutrition and hydration to be withdrawn.

Read the full text of the judgment on Bailii

The court ruled that the Patient had capacity to decide not to accept life sustaining treatment and the court had no jurisdiction to interfere with the decision making process. Accordingly, although rightly brought, the application of the Trust for declarations under the Mental Capacity Act 2005 were dismissed.

Read the full text of the judgment on Bailii

The Patient had been in a permanent vegetative state for at least 5 years. This case concerned an application for declarations that it was not in the Patient's best interests for clinically assisted nutrition and hydration to be continued, and that it was lawful and in her best interests for clinically assisted nutrition and hydration to be withdrawn. The declarations were made.

Read the full text of the judgment on Bailii