Supreme Court ruling shows importance of making end of life wishes known
Today, the Supreme Court ruled in the case of Aintree University Hospitals NHS Foundation Trust vs James. This sad case highlights the extremely difficult position of medical professionals and family members in trying to make decisions about the best interests of a seriously ill patient who does not have capacity to make decisions about their medical treatment themselves.
Mr David James was diagnosed with colon cancer in 2001 and was admitted to hospital in March 2012 where he picked up an infection. Medical staff agreed that Mr James had a less than 1% chance of recovery so decided in his best interests that treatment should be withdrawn if his condition deteriorated further. Although Mr James had not made any formal expression regarding his own treatment the decision by Aintree Hospital was opposed by Mr James’ family on the basis of his determination to fight his cancer when first diagnosed.
Today the Supreme Court upheld the earlier decisions both of the Court of Protection and the Court of Appeal in this case. In September 2012 the Court of Protection had decided against Aintree and agreed with Mr James’ family that it would not be in his best interests for treatments to be withheld from him in the event of a clinical deterioration. In December 2012 the Court of Appeal overturned the Court of Protection decision and upheld Aintree’s appeal that it would not be in his best interests to withhold treatment in the event of a further deterioration. This was on the basis of evidence of Mr James’ further significant decline in health since the Court of Protection hearing.
Danielle Hamm, Director of Compassion in Dying, said:
“In this important judgment, the Supreme Court has emphasised that doctors making best interests decisions for patients who lack capacity must place significant weight on the patient’s own views.
“This is why completing an Advance Decision, or appointing a Lasting Power of Attorney, is incredibly important and something which needs to be done when a person is mentally competent. Without an emphasis on advance care planning, situations such as the one faced by Mr James’ family and the medical staff at Aintree will continue to happen.
“We know from our recent poll that 70% of people would want little or no medical treatment given to them when they are dying, but almost half wrongly believe these decisions can be made by family members. Compassion in Dying is committed to making sure end of life rights becomes an integral part of people’s care so that people can have the care that they want.”
Compassion in Dying’s free Information Line receives over 200 calls each month from people wanting to know more about how they can ensure their medical treatment wishes are respected if they lose mental capacity.
