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Family in legal battle with NHS trust over ending man’s life-sustaining care


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The case is being heard at the Royal Courts of Justice in central London (Nick Ansell/PA)

The son of a man who is “minimally conscious” in hospital has said he “cannot accept” the prospect of a judge ruling that his father’s life-sustaining treatment should be withdrawn.

The man, known only as XY for legal reasons, suffered severe brain damage following a cardiac arrest which caused a “prolonged disorder of consciousness”.

The NHS trust which cares for him is asking the Court of Protection, a specialist family court, to rule that XY cannot make decisions regarding his care and that the ventilation and clinically assisted nutrition and hydration which are keeping him alive should stop.

I cannot accept you taking him off the machine, knowing very well that will initiate the beginning of the end
Son of XY

Lawyers for the trust, based in London, told a hearing on Wednesday that treatment is no longer in XY’s “best interests” as he has a “profound neurological injury from which he cannot recover”.

But XY’s family opposes the application, believing that doctors have underestimated his level of awareness, that he responds to being touched by family members, and that he would not want his treatment to be withdrawn.

Giving evidence in court on Wednesday, XY’s son said his father was an “amazing man”.

He said: “Although he can’t respond back to us, I feel like he is here in spirit.

“He just gives us a friendly ear, and we feel that we get through to him.”

He continued: “He is fighting. He is trying so hard and we believe through the power of love, support, and medical expertise, he may get better, but even if he does not get better, if he slowly deteriorates, we can accept that as well.

“But I cannot accept you taking him off the machine, knowing very well that will initiate the beginning of the end.”

He added that he believed his father would “100%” prefer to live in his current state if the alternative was death.

In light of the chronic, enduring and irreversible nature of his condition, the lack of any prospect of significant recovery, and the likelihood of his suffering distress at the treatment provided to him, the trust has reached the conclusion that continued treatment is no longer in (XY’s) best interests
Nicola Kohn, representing the NHS trust

Peter Mant, representing the family, said in written submissions that despite XY’s “lack of awareness’, his relatives felt he was able to respond to prompts and appeared to react to their voices in hospital.

He said: “(XY’s) life, whilst extremely limited, has an inherent value; he experiences limited, if any, pain and is otherwise comfortable; he spends time with his family and appears to relax in their presence; and, most importantly of all, his current life is a life that that he would want to sustain through treatment.”

Mr Mant said that the family recognised that while the chance of a “meaningful” recovery was “extremely limited”, medics estimated that he could live for several years if treatment continued.

The court was told that XY was a “much-loved husband and father” and a lifelong football fan who led a “rich spiritual and social life grounded in his local community”, with several relatives attending court in London.

But a physician involved in XY’s care said in their evidence that he was at the “lowest end of the awareness spectrum”, adding that there had been “limited progress” during his time in hospital.

They added that nurses caring for XY “don’t think they are doing the right thing for him” by continuing treatment.

Nicola Kohn, representing the NHS trust, said in written submissions that medical evidence was “unanimous” and concluded that XY “can have no meaningful interactions with the world, save, possibly, for the experience of pain”.

If treatment was withdrawn, XY would receive palliative care, with death expected within three weeks, Ms Kohn said.

She said: “In light of the chronic, enduring and irreversible nature of his condition, the lack of any prospect of significant recovery, and the likelihood of his suffering distress at the treatment provided to him, the trust has reached the conclusion that continued treatment is no longer in (XY’s) best interests.”

The hearing before Mr Justice Hayden is set to conclude on Thursday.

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