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Judge upholds doctors’ “do not resuscitate” recommendation in event of patient’s condition getting worse

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e6822 (Published 09 October 2012) Cite this as: BMJ 2012;345:e6822
  1. Clare Dyer
  1. 1BMJ

A High Court judge has upheld the decision by several doctors not to resuscitate or ventilate a 55 year old Muslim man in a “minimally conscious state” should his condition worsen, over-riding the objections of his family.

The father of eight from Greater Manchester, named only as “Mr L,” was severely brain damaged after a third cardiac arrest in July and was initially thought to be in a persistent vegetative state. The case went to the High Court after his family challenged Pennine Acute Hospitals NHS Trust’s decision not to attempt resuscitation or ventilation in the event of a cardiac or respiratory arrest.

The family argued that their Muslim faith required that life should be preserved “until God takes it away.” The hearing was adjourned in August for L’s condition to be reassessed after an independent expert witness cast doubt on the diagnosis of persistent vegetative state.

When the case resumed, the doctors treating Mr L told Mr Justice Moylan that they accepted that he was in a minimally conscious state but concluded that it would not be in his interests to undergo the pain and distress of attempted resuscitation or other intensive care.

“All we would be doing is prolonging the dying process and causing pain and distress for the patient and almost certainly increasing his brain damage,” a doctor caring for him told the judge.

Moylan ruled that the balance was “firmly in favour” of a declaration that it would be lawful not to attempt resuscitation or ventilation. The judge accepted that it sounded “harsh” but said that the treatment would prolong L’s death without prolonging his life “in any meaningful way.”

He added, “It would result in death being characterised by a series of harmful interventions without any realistic prospect of such treatment producing any benefit.”

The judge refused the family permission to appeal, although it is open to them to ask the Court of Appeal itself to hear an appeal.

Notes

Cite this as: BMJ 2012;345:e6822