High Court, Family Division

Published date01 October 2002
DOI10.1177/002201830206600503
Date01 October 2002
Subject MatterArticle
High Court, Family
Division
Consent to
the
Withdrawal
of Medical Treatment
BvNHS
Hospital
Trust [2002] 2 All ER
449
B
had
been
left tetraplegic following
the
rupture
of a blood vessel in
her
neck and, despite surgery,
which
had
only slightly improved
her
condi-
tion, was left reliant
on
an
artificial respirator. She
had
requested
that
the
Trust
turn
off
her
ventilator
and
this request
had
been
refused. B
thus
applied for a declaration from
the
High Court
that
she possessed
the
necessary
mental
capacity to give or refuse consent to medical
treatment
and
sought
nominal
damages in relation to
the
treatment
given to
her
by
the
Trust against
her
consent.
The issues for
the
High Court to consider were:
1. Did B have
the
mental capacity to refuse
treatment
in circum-
stances in
which
refusal
would
almost inevitably lead to death?
2. Did she have
the
capacity to make a choice as to
whether
to
continue
with
medical support from
August
2001?
If
yes:
3. Was she entitled to
nominal
damages due to
the
tort of trespass to
the
person committed by
the
Trust in acting contrary to
her
wishes?
HELD,
GRANTING
THE
DECLARATIONS
SOUGHT
IN
FAVOUR
OF
THE
APPLI-
CANT,
amentally
competent
patient with aserious physical disability
had
the
same right to personal
autonomy
as
anyone
else
and
it was
stated
that
doctors should
not
confuse these issues
with
those of severity
of consequences. In this case, B
had
the
required mental capacity at
the
material time
and
the administration of artificial respiration against
her
wishes was an unlawful trespass by
the
Trust.
The court came to its decision based on
the
following
considerations:
1. The issue was
not
one
of life or death
but
rather
that
of legal
competence to make
the
decision as to discontinuance of treat-
ment.
Unless
the
gravity of
an
illness affected apatient's compe-
tence, aseriously disabled person
had
the same rights to respect for
her
autonomy
as
anyone
else.
2. Abalancing act
had
to be carried
out
between
autonomy
and
the
sanctity of life.
3. There was a presumption of mental capacity with its assessment
largely
dependent
on expert medical evidence. B was
competent
to
make
all relevant decisions and,
where
competence was
not
in
issue, a patient's decision to refuse
treatment
was to be
respected.
391

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