Court case adjourned after diagnosis of persistent vegetative state changes

BMJ 2012; 345 doi: (Published 28 August 2012) Cite this as: BMJ 2012;345:e5803
  1. Clare Dyer
  1. 1BMJ

The case of a severely brain damaged man at the centre of a dispute between his family and his doctors has been adjourned after an independent expert cast doubt over the diagnosis of persistent vegetative state.

Doctors believed that the 55 year old father of eight from Greater Manchester was in a persistent vegetative state after a cardiac arrest six weeks ago. They had asked the Court of Protection to rule that it would not be in his best interests to resuscitate or ventilate him if his condition worsened.

The court had been asked to resolve the disagreement between Pennine Acute Hospitals NHS Trust and the man’s family, who argued that he had some awareness and that measures should be taken to keep him alive.

But the case has been adjourned till 1 October after an independent expert, neurologist Peter Newman, who viewed videotaped footage of him grimacing and closing his eyes while being washed, said that the man, known as L, was “most likely” in a minimally conscious state.

Jenni Richards QC, for the trust, said the family believed that further improvement might take place, possibly even leading to some verbal communication.

She added: “The trust is, I understand, putting in process the arrangements for a multidisciplinary meeting, including neurology.” Claire Watson, for the trust, told Mr Justice Moylan, “Clearly there has been a change in diagnosis.” But she said it had not yet been possible “to obtain a definitive view from the treating clinicians at the hospital whether or not that will alter their care plan for L.”

Vikram Sachdeva, counsel for the official solicitor, who represents L’s interests, said, “The position today has changed in a significant manner.” He told the judge that the trust’s assertion that there had been no meaningful movement on L’s part was “probably not accurate” but added that it was possible that L was more responsive in the evenings when the family visited.

Last September, in what was thought to be the first case of a minimally aware patient to reach the Court of Protection, Mr Justice Baker rejected a plea by a 52 year old woman’s partner and sister for artificial nutrition and hydration to be withdrawn.

He said that the preservation of life was an important principle and concluded that the woman, who was brain damaged in 2003, had “some positive experiences.”1


Cite this as: BMJ 2012;345:e5803