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Landmark ruling on end-of-life decisions for patients in a vegetative state

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Families of patients in a vegetative state will no longer have to consult a judge when deciding to stop their end-of-life care following a landmark court decision.

The Supreme Court made the ruling as it quashed an appeal regarding a case in which relatives of a man left in a permanent coma by an extensive brain injury decided to withdraw the treatment keeping him alive.

Experts had deemed that the man – a 52-year-old financial analyst who can only be identified as Mr Y – would likely never regain consciousness, having fallen ill after suffering a cardiac arrest in June last year.

Even if he had, they concluded he would have suffered from profound mental and physical disability.

Although Mr Y had not drawn up any advance decision as to whether to refuse treatment, his family and medical team agreed it would be in his best interests for his feeding tube to be cut.

It meant he would likely die within three weeks.

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The ruling on Mr Y was upheld at the Supreme Court

In November, a High Court judge ruled that it was not necessary for them to bring the matter to court beforehand.

My Y died in December, but an appeal by a solicitor representing people who lack capacity was granted because of the general importance of the issues raised by the case.

Richard Gordon QC argued that common law or EU human rights law should require that any case involving the withdrawal of such treatment should be subject to an application as to whether it is in the best interests of the patient.

He said such cases should be brought to court regardless of whether or not there was an agreement between relatives and doctors.

Justices at the Supreme Court have now unanimously dismissed his argument.

Justice Lady Black explained that having looked at the issue “in its wider context as well as from a narrower legal perspective”, she did not believe common law or human rights law made it necessary for a court to rule on such matters.

“If the provisions of the Mental Capacity Act are followed and the relevant guidance observed, and if there is agreement upon what is in the best interests of the patient, the patient may be treated in accordance with that agreement without application to the court,” she said.

Lady Black acknowledged that there could be occasional cases in which circumstances would make an application required or desirable, but said that generally decisions such as those involving Mr Y should be made without court input.

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