A judge in the Court of Protection has endorsed a Do Not Attempt Resuscitation (DNAR) order for a man in a minimally conscious state.
In Sheffield Teaching Hospitals NHS Foundation Trust v TH & Anor, the man, called ‘TH’ in the judgment, was admitted to a Sheffield hospital in February having fallen into a coma.
The doctors told the court that TH was “under a serious neurological disability”.
They also identified several health issues which they were able to treat but agreed that he had shown no signs of neurological improvement.
According to the doctors, TH was unable to properly feed himself and incontinent.
A neurological expert brought in to consult on the case did not consider that TH could get better, and that the care he could be given would be “nursing care rather than rehabilitation”.
The Trust applied to the Court of Protection in order to secure TH’s continuing treatment, possibly at a specialist nursing home, but this was opposed by his ex-wife and long-term partner, ‘TR’, and a long-time friend.
They argued for TH to be sent home in their care, claiming that TH wanted to die as quickly and painlessly as possible.
TR, while “full of respect and genuine admiration” for the doctors and nurses, argued that TH would “loathe” his current situation and see it as a “violation of his dignity”.
Mr Justice Hayden noted that despite TR saying she was “not ready to let him go”, she felt that she would be failing him if she did not fully articulate his views to the court.
From the evidence given by several of TH’s friends, the judge was able to gain a very good idea about the man’s wishes, despite the fact that he could no longer communicate with anyone, verbally or non-verbally.
“If ever a court heard a holistic account of a man’s character, life, talents and priorities it is this court in this case.”
He added that it was clear that TH’s wishes would be to “end his days” with his ex-wife and his friend, rather than a hospital or nursing home.
Mr Justice Hayden approved of the DNAR order already in place but in relation to the withdrawal of nutrition and hydration he adjourned the issue until a clinical assessment can be made.