Judges support doctors' decision to stop treating dying man
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《英国医生杂志》
The relatives of an 86 year old Muslim man with multiple organ failure have lost their legal battle to keep him on life support, after the rejection of their last possible appeal.
The man, who for legal reasons is known only as Mr A, has been in hospital since July. The NHS trust responsible for the hospital, which also cannot be named, won permission from the High Court on 26 July to cease dialysis and to forego attempting resuscitation in the event of respiratory failure. But the trust was told not to act on the decision until the family had had time to appeal.
That appeal was heard on 1 September, but Lord Justice Waller, sitting with Lord Justice Mummery and Lord Justice Scott Baker, set aside the family's argument that "only God has the power to bestow death."
The family had offered evidence from a retired consultant, referred to as Dr R, who said that Mr A stood a chance of recovering sufficiently to move home into the care of his family. But Mr A's doctors and an independent specialist appointed by the official solicitor agreed that his organ failure was irreparable and that further treatment was not in his best interests.
Lord Justice Waller said that relatives' wishes were a "highly material factor" in such cases, but not necessarily "the governing factor."
"It is only lawful to treat an unconscious patient, who cannot consent, if to do so is in their best interests," he said. "These are hard cases. They are hard for the families of patients; they are hard for the doctors treating them. My sympathy goes out to all, particularly the family. I hope they can now accept that Mr A should be allowed to die peacefully and with dignity."
A world war two veteran with a distinguished record, Mr A developed severe complications from a heart attack immediately after returning to Britain from a visit to his native Pakistan, where he has endowed several hospitals and mosques.
Debra Powell, representing the NHS trust, told the court that continued intervention could amount to "inhuman treatment" under the European Convention on Human Rights. As far as doctors could divine his wishes, she said, they believed that Mr A himself wanted his ordeal to end. He could not speak, but had physically resisted treatment on several occasions.
Finding that further treatment would be "futile and invasive," the Court of Appeal ruled that Mr A's interests would be best served if he were allowed to die a "natural, pain-free, and dignified death."
In a statement issued after the decision, the NHS trust expressed sympathy for the family's position, and promised to "continue to communicate with them and offer all appropriate support at this distressing time."
Mark McGhee, the family's solicitor, said that Mr A's eldest son left halfway through the hearing "telling me that he did not want to hear the death sentence pronounced on his father."
Mr McGee added, "Since this was the Court of Appeal, we now for the first time have case law on this question. Other judges will refer to this case in future decisions of this sort."(Owen Dyer)
The man, who for legal reasons is known only as Mr A, has been in hospital since July. The NHS trust responsible for the hospital, which also cannot be named, won permission from the High Court on 26 July to cease dialysis and to forego attempting resuscitation in the event of respiratory failure. But the trust was told not to act on the decision until the family had had time to appeal.
That appeal was heard on 1 September, but Lord Justice Waller, sitting with Lord Justice Mummery and Lord Justice Scott Baker, set aside the family's argument that "only God has the power to bestow death."
The family had offered evidence from a retired consultant, referred to as Dr R, who said that Mr A stood a chance of recovering sufficiently to move home into the care of his family. But Mr A's doctors and an independent specialist appointed by the official solicitor agreed that his organ failure was irreparable and that further treatment was not in his best interests.
Lord Justice Waller said that relatives' wishes were a "highly material factor" in such cases, but not necessarily "the governing factor."
"It is only lawful to treat an unconscious patient, who cannot consent, if to do so is in their best interests," he said. "These are hard cases. They are hard for the families of patients; they are hard for the doctors treating them. My sympathy goes out to all, particularly the family. I hope they can now accept that Mr A should be allowed to die peacefully and with dignity."
A world war two veteran with a distinguished record, Mr A developed severe complications from a heart attack immediately after returning to Britain from a visit to his native Pakistan, where he has endowed several hospitals and mosques.
Debra Powell, representing the NHS trust, told the court that continued intervention could amount to "inhuman treatment" under the European Convention on Human Rights. As far as doctors could divine his wishes, she said, they believed that Mr A himself wanted his ordeal to end. He could not speak, but had physically resisted treatment on several occasions.
Finding that further treatment would be "futile and invasive," the Court of Appeal ruled that Mr A's interests would be best served if he were allowed to die a "natural, pain-free, and dignified death."
In a statement issued after the decision, the NHS trust expressed sympathy for the family's position, and promised to "continue to communicate with them and offer all appropriate support at this distressing time."
Mark McGhee, the family's solicitor, said that Mr A's eldest son left halfway through the hearing "telling me that he did not want to hear the death sentence pronounced on his father."
Mr McGee added, "Since this was the Court of Appeal, we now for the first time have case law on this question. Other judges will refer to this case in future decisions of this sort."(Owen Dyer)