Kings College NHS Foundation Trust v C and Anor
The Honourable Mr Justice MacDonald has published his judgment in Kings College Hospital NHS Foundation Trust v C and Anor at https://www.bailii.org/ew/cases/EWCOP/2015/80.html.
C was described as having “led a life characterised by impulsive and self-centred decision making without guilt or regret….a person who seeks to live life entirely, and unapologetically on her own terms; that life revolving largely around her looks, men, material possessions and ‘living the high life’. In particular, it is clear that during her life C has placed a significant premium on youth and beauty and on living a life that, in C’s words, ‘sparkles’.”
C was diagnosed with breast cancer in 2014 and subsequently attempted suicide. “The consequences of C’s attempted suicide have been grave and are described in detail in C’s medical records and in the statements of Dr L, liver consultant and Dr S, consultant nephrologist. In summary, as a result of her paracetamol overdose C suffered an injury to her liver and an acute injury to her kidneys. Since admission to hospital C has, consequently, required renal replacement therapy. That therapy was provided initially by a ‘filtration’ machine and thereafter by intermittent haemodialysis for four hours three times per week.”
“Dr S makes clear that if C does not have further dialysis and continues to have minimal kidney function, she will become progressively unwell as levels of potassium and acid in her blood increase to dangerous levels. These levels will typically become life threatening between three and seven days following the last haemodialysis session. If C drinks during this period then she will also endure fluid build up on her lungs and insufficient oxygen in her bloodstream as a result. The risks of a sudden cardiac event or deterioration will increase after more than three days without dialysis. If C’s kidney function remains poor and she passes very little urine, it is likely that C will die within five to ten days of having no dialysis. C would become progressively drowsy and possibly confused after several days although a sudden cardiac arrest and death is possible at any point.”
“It is within the context of this background C now refuses to undertake further haemodialysis.”
In deciding that C had capacity to refuse treatment, The Honourable Mr Justice MacDonald emphasised that “where a patient refuses life saving medical treatment the court is only entitled to intervene in circumstances where the court is satisfied that the patient does not have the mental capacity to decide whether or not to accept or refuse such treatment. Where the court is satisfied, on the balance of probabilities, that the patient lacks capacity in this regard, the court may take the decision as to what course of action is in the patient’s best interests”.
For advice on vulnerable or older adults, including Court of Protection please contact Holly Chantler, Morrisons Solicitors LLP on 01737 854 500 or email [email protected] or visit https://www.morrlaw.com/wills-estates-tax-planning/