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MS sufferer should be allowed to die, says judge in landmark ruling MS sufferer should be allowed to die, says judge in landmark ruling
(about 5 hours later)
A judge has ruled that a 68-year-old woman in the end stage of multiple sclerosis should be allowed to die. A woman in the end stage of multiple sclerosis has been granted the right to die, in a landmark legal ruling.
The woman’s daughter had told how her mother was completely incapacitated and had asked Mr Justice Hayden to allow medics to stop providing clinically assisted nutrition and hydration. The woman’s daughter had told how her mother was “completely incapacitated” and had asked Mr Justice Hayden to allow doctors to stop providing “clinically assisted nutrition and hydration”.
Granting the application on Thursday, the judge said he had concluded that it would be disrespectful to the woman to keep her alive in a manner she would “regard as grotesque”. Medical experts said the woman, who cannot be named for legal reasons, was in a “minimally conscious state”, however the judge concluded that it would be disrespectful to the woman to keep her alive in a manner she would “regard as grotesque”.
He said the focus of the case was right to live “at the end of her days” in the way that she would have wished. [The woman] lacks capacity to litigate or indeed in any aspect of decision making,” said Mr Justice Hayden in his ruling. Granting the application on Thursday, he said the focus of the case was her right to live the last of her days in the way that she would have wished.
“[The woman] now 68 years old is profoundly impaired both physically and cognitively in consequence of the progressive degenerative impact of multiple sclerosis. It is now 23 years since [she] received her diagnosis.”“[The woman] now 68 years old is profoundly impaired both physically and cognitively in consequence of the progressive degenerative impact of multiple sclerosis. It is now 23 years since [she] received her diagnosis.”
Hayden said he wanted the woman’s family to know the decision was his, adding: “It is made on the broadest survey of a wide canvas of opinion. It is not on the evidence of any one individual.” The judge had said during the hearing that he could not contemplate a more difficult decision. He said his decision was an evolution in case law. The woman, who is being cared for at a specialist unit in north-west England, is a former hairdresser. Her daughter told the court that her immaculate appearance was part of her belief system.
Hayden had analysed the case earlier this month at a public hearing in the court of protection – where issues relating to sick and vulnerable people are considered–- in London. She told the judge: “I cannot emphasise enough how much the indignity of her current existence is the greatest contradiction to how she thrived on life and, had she been able to express this, then without a doubt she would.”
The judge had taken into account the views of the daughter, other relatives, medics involved in her mother’s treatment, carers, independent medical experts as well as lawyers he had appointed to represent the woman. No one involved in the case was opposing the application made by the daughter. “My mum’s immaculate appearance, the importance she placed on maintaining her dignity and how she lived her life to its fullest is what formed her belief system; it’s what she lived for,” the daughter said. “All of that is gone now and very sadly my mum has suffered profound humiliation and indignity for so many years.
Hayden ruled the woman, a former hairdresser who is being cared for at a specialist unit in north-west England, cannot be identified. Lawyers who represented her daughter described the ruling as a landmark. As well as hearing from the daughter, Hayden was presented with the views of other relatives, medics involved in her treatment, carers, independent medical experts and lawyers he had appointed to represent the woman earlier this month.
Experts had told the judge how they thought the woman was in a “minimally conscious state”. They said she could fix her vision and follow a moving object. No one involved opposed the daughter’s application.
Mathieu Culverhouse, a specialist court of protection lawyer withIrwin Mitchell, the law firm Irwin Mitchell representing the woman’s daughter, said the decision was the first of its kind. Four years ago, a brain-damaged, minimally conscious 52-year-old woman was denied the right to die by another judge.
“This landmark decision is the first time that the court of protection has agreed to withdraw treatment from someone receiving life sustaining treatment while considered by medical experts to be in a ‘minimally conscious state’,” said Mr Culverhouse. Mr Justice Baker’s ruling at the time was hailed as a decision which clarified the law relating to the care of the severely disabled.
“However, all cases of this kind are decided on their own facts and judges will always examine all the evidence presented to them, including that presented by the patient’s family affected, on an individual basis.” He had said there was dignity in the life of a disabled person who was well-cared for and kept comfortable and so concluded that life-supporting treatment should not be withdrawn.
He continued: “The situation is distressing for all of those involved but after hearing all the evidence from the family, carers and medical experts presented to the court, the judge has decided that withdrawing the life-sustaining treatment is in the woman’s best interests given her current quality of life. He said the 52-year-old had some positive experiences which could be extended.
Responding to the decision made today, Davina Hehir, director of policy at campaign group Compassion in Dying, said: “This case represents a landmark for the courts taking into account a person’s previously expressed wishes when deciding what treatment they would or would not want.
“The experience of the family in this case must have been harrowing and our hearts go out to them. People can help to avoid these distressing cases by planning ahead for their own treatment.”
Hayden said during the hearing that he could not contemplate a more difficult decision and that his ruling was an evolution in case law.
Mathieu Culverhouse, a specialist court of protection lawyer based at law firm Irwin Mitchell, which represented the woman’s daughter, also said the decision was the first of its kind.
“This is the first time that the court of protection has agreed to withdraw treatment from someone receiving life sustaining treatment while considered by medical experts to be in a ‘minimally conscious state’,’ he said.
“The judge has decided that withdrawing the life sustaining treatment is in the woman’s best interests given her current quality of life,” he said.
“While this is clearly distressing for her daughter, she is relieved that the court has been able to review and examine the expert medical evidence available and hear detailed legal argument before making a decision which will now end her mother’s suffering and indignity.”“While this is clearly distressing for her daughter, she is relieved that the court has been able to review and examine the expert medical evidence available and hear detailed legal argument before making a decision which will now end her mother’s suffering and indignity.”
Lawyers said arrangements would be made for treatment to be withdrawn in line with national clinical guidelines. The woman’s daughter had told the court that continuing treatment would be against her mother’s wishes. Campaigners who oppose assisted dying warned the ruling could put vulnerable sick or disabled people at risk. Peter Saunders, director of Care Not Killing said: “This case demonstrates judicial mission creep whereby judges, through subjective application of vague and ambiguous legal precedent, are able to shape and remake the law.
“My mum’s immaculate appearance, the importance she placed on maintaining her dignity and how she lived her life to its fullest is what formed her belief system; it’s what she lived for,” the daughter said. All of that is gone now and very sadly my mum has suffered profound humiliation and indignity for so many years. “In so doing they erode legal protection for vulnerable people and give an invitation to those who wish to rid themselves of a financial or emotional care burden to push the envelope even further.”
“I cannot emphasise enough how much the indignity of her current existence is the greatest contradiction to how she thrived on life and, had she been able to express this, then without a doubt she would.” In the case, the woman’s interests were represented by the Office of the Official Solicitor, which provides legal help to mentally ill people.
Four years ago, another judge ruled that a brain-damaged, minimally conscious 52-year-old woman should not be allowed to die. Mr Justice Baker’s ruling was hailed as a landmark decision, which clarified the law relating to the care of the severely disabled. He had said there was dignity in the life of a disabled person who was “well cared for and kept comfortable”, and concluded that life-supporting treatment should not be withdrawn. Her lawyers initially said the judge should conclude that there was a “strong presumption in favour of the benefits of continuing life”.
Baker said the 52-year-old had some positive experiences which could be extended. He ruled the woman could not be identified. He had said an English court had never before been asked to consider whether life-supporting treatment should be withdrawn from a patient who was not in a persistent vegetative state but was minimally conscious. But after hearing evidence, they altered their view and said they had decided to support the application.
His decision came nearly two decades after leading judges ruled that Liverpool football fan Tony Bland – left in a permanent vegetative state after being crushed at the 1989 Hillsborough stadium disaster – could be allowed to die. Arrangements will now be made for treatment to be withdrawn in line with national clinical guidelines.
Hayden had heard legal argument from lawyers representing the woman’s daughter and lawyers representing two health organisations involved in her care.
The woman’s interests were represented by the Office of the Official Solicitor, which provides legal help to mentally ill people. Lawyers instructed by the official solicitor initially said the judge should conclude that there was a “strong presumption in favour of the benefits of continuing life”.
But they altered their view after hearing evidence and said they had decided to support the application. Hayden said he was satisfied the woman’s views had found “real and authoritative expression” through her family at the hearing.