Joseph O’Brien KC and Laura Twist successfully oppose an application for the withdrawal of CANH in the Court of Protection
Joseph O’Brien KC and Laura Twist successfully represented the daughter of ‘PK’ in this serious medical treatment case in the Court of Protection. They secured an order that it was in PK’s best interests to continue to receive clinically assisted nutrition and hydration via a nasogastric tube.
The case was brought by the University College London Hospitals NHS Trust. PK is an inpatient on their ward following a catastrophic stroke in October 2024 which had left him both physically and cognitively impaired, fully dependent on others to meet his needs and unable to speak. PK is fed via a nasogastric tube due to an unsafe swallow. The Trust’s application was made on the basis that there was no prospect of recovery and therefore it was no longer in his best interests to continue to receive clinically assisted nutrition and hydration via his nasogastric tube.
The application was opposed by PK’s daughter (AB), who believed that her father, a devout Muslim and family man, would not have wanted the tube to be removed. She believed that he still gained joy from his family’s visits to the hospital ward and that he would have always accepted treatment on offer to him if he was able to make the decision for himself. AB was supported in her views by her mother and siblings.
It was accepted by all parties that PK was conscious, aware of his surroundings and able to interact with his family, albeit limited by his cognitive and physical impairments. The case is one of the first to deal with a patient who is not in a prolonged disorder of consciousness and who would likely not have consented to the removal of the tube if he had retained capacity to make the decision for himself. The court heard and accepted arguments on behalf both AB and PK, via the Official Solicitor, that treatment was not futile because it kept him alive notwithstanding that he would not recover and that PK’s wishes and beliefs could not be outweighed by the burdens of treatment as they currently stood.
It is an important case that looked at whether treatment could be futile if there is no prospect of recovery and whether a patient’s wishes should be paramount even where the clinical evidence diverges on the issue of best interests.
Joseph O’Brien KC and Laura Twist were instructed by Helen Ingleson and Chloe Moran of Irwin Mitchell.
