County Durham & Darlington NHS Foundation Trust v PP & Ors
2014
COURT OF PROTECTION
United Kingdom
CORAM
- MR JUSTICE COBB
Areas of Law
- Health Law
- Human Rights Law
2014
COURT OF PROTECTION
United Kingdom
CORAM
AI Generated Summary
The County Durham and Darlington NHS Foundation Trust sought court declarations regarding the treatment of an 85-year-old woman (PP) lacking capacity due to severe medical conditions. The court held that PP lacked capacity to make medical decisions and that it was in her best interests to continue artificial hydration but withhold artificial nutrition and not resuscitate her in the event of cardiac or respiratory arrest. The judgment emphasized the best interests of the patient, presumption of capacity, and the principle that life-sustaining treatment should not be motivated by the desire to bring about death.
Judgment
The Honourable Mr. Justice Cobb :
These Court of Protection proceedings are being heard in public, pursuant to the provisions of rule 92(1)(a) of the Court of Protection Rules 2007 and, having regard to the subject matter, under §16 of PD9E to the Court of Protection Rules 2007 . A Reporting Restriction Order pursuant to rule 92(2) Court of Protection Rules 2007 was made on 19 June 2014 by Roderic Wood J, and (subject to a minor amendment), that order subsists as originally drawn, restricting the public identification of the subject of the proceedings.
By application dated 12 June 2014, County Durham and Darlington NHS Foundation Trust (hereafter The Trust) seek declarations in relation to PP (‘P’). P was born on 17 May 1929, and is therefore 85 years old. P is currently at the Darlington Memorial Hospital, Hollyhurst Road, Darlington, where she was taken on 9 April 2014 following a gradual decline in her functional status as observed by those providing care for her at her care home, which I shall refer to as Ivy Dene Nursing Home.
P has a complex medical history, most notably having suffered a left posterior acute circulation stroke some years ago; she currently suffers from atrial fibrillation and “ stroke disease ”. Her current diagnosis further includes (a) vascular dementia and possible Alzheimer’s with diminished consciousness, (b) ischaemic encephalopathy, (c) and cerebro-vascular disease. She is described by a number of the medical professionals as being “ very frail ”, has no eye contact, appears unconscious, and is unable to communicate or respond to any requests or commands. She is acknowledged by the clinical and forensic experts to be in a terminal phase of her life.
The Trust seeks the Courts authority, and corresponding declarations, as to P’s treatment, in particular the possible withdrawal, or non-escalation of, life-sustaining treatment as part of an end of life care package. The Trust contends (and interim declarations have been made to this effect already) that P lacks the capacity to litigate, and to make decisions in relation to the serious medical treatment in issue in this application. Specifically the Trust seeks the following declarations pursuant to section 15(1)(c) of the Mental Capacity Act 2005 :
That it is lawful and in P’s best interests to continue to receive artificial hydration via subcutaneous injection.
That it is lawful and in P’s best interests that the Trust’s treating clinicians shall be permitted:-