Family in Dispute Over Care of Brain Damaged Woman

A family is in dispute over the best course of action to take in the case of a woman with brain damage. The woman, identified only as ‘Mrs P,’ entered a “minimally conscious state” after a fall in 2016. She is currently being looked after on an acute hospital ward at Salford Royal Hospital.

The woman’s partner and daughters feel that she should be provided with palliative care and that it is not in her best interests to continue to provide her with clinically assisted nutrition and hydration. They are in dispute with her sisters, who feel that an artificial feed should be maintained in case there are improvements in her condition.

A Court of Protection judge is being asked to consider whether she should continue to receive care. In court, the judge was provided with an email written by Mrs P, now 72, to one of her daughters, more than three-and-a-half years before her accident.

In the email, she wrote: “Did you see that thing on dementia? Made me think of dad and what a travesty of life his last years were, all the sadder as he had such an incredible talent.”

She added in the email: “You know I miss Mum every day and still talk to her but it is a comfort that she went quickly and I’m still haunted by how he ended up … Get the pillow ready If I get that way?”

Sister argues removal of feeding tube would be ‘legalised killing’

Joseph O'Brien, for the NHS trust, told the court: “Very early on, Mrs P's daughters were expressing the view to the clinicians that she would not wish to have any treatment which would continue her existence, her life, if she, in fact, was suffering from brain damage.”

Mr O'Brien also referenced conversations with friends and neighbours, in which Mrs P had reiterated the actions she would like to be taken “in the event she found herself either with dementia or with any cognitive problems.”

However, he also stated: “There is a strong presumption about the preservation of life. On the evidence we've seen so far there is nothing that's strong enough to rebut the notion that in the circumstances she currently finds herself, she would wish treatment to be discontinued.”

Mrs P’s sisters have argued that their sibling would wish to be given the chance for her condition to improve. One sister told the court that removing their sister’s feeding tube would be a form of “legalised killing.” Mrs P’s other sister stated that the medical profession should be the judge of whether it would be best to provide her with ongoing treatment.

The NHS foundation trust responsible for Mrs P’s care has applied to the court to move her to a specialist nursing home, where her care can be continued.

Debate between medical experts

Two expert witnesses told the court there would be no further change in Mrs P's underlying neurological state, but they differed on whether nutrition and hydration should continue.

One expert has stated that she will not improve in terms of social engagement or quality of life. In contrast, the second expert has argued that she often shows enjoyment and engagement with therapy and nursing staff, and as such, she may improve in a different environment.

Official solicitor changes his opinion

Vikram Sachdeva, QC, counsel for the official solicitor and appointed to represent Mrs P’s interests in the courtroom, said on the third and final day of the case that he had changed his previously neutral stance on her future care. He said he now shared the daughters’ view that the tube should be withdrawn and Mrs P be in receipt of palliative care.

Contact IBB Solicitors' Court of Protection Experts

IBB Solicitors has niche expertise on applications to the Court of Protection and three of our solicitors are members of the Court of Protection's panel of professional deputies. For advice, contact a member of the Wills, Trusts and Probate team, call us on 03456 381381 or email enquiries@ibblaw.co.uk.