A judge in the Court of Protection has allowed doctors to stop feeding a woman in a ‘minimally conscious state’ (MCS) through artificial means.
An MCS is a medical condition in which the victim has severely limited mental functions. It differs from a persistent vegetative state in that there is still some awareness intact.
In United Lincolnshire Hospitals NHS Trust v N, the woman, in her mid-fifties, suffered a haemorrhage which caused brain damage. Despite being treated at a hospital which specialises in neurological conditions, she did not recover.
Her discharge letter from the hospital said she had severe impairments to her ability to communicate and respond to her surroundings.
During the course of her various treatments the patient had been fed with a feeding tube which she repeatedly attempted, sometimes successfully, to remove by force. Several attempts were made by doctors to reinsert the tube but they were met with significant physical resistance every time.
Doctors came up with possible approaches to get a feeding tube put back in, but they all involved invasive surgical procedures.
The woman’s daughter made a statement that her mother “would not be comfortable living as she does now”. The daughter recalled that her mother once said she “would not like to continue life in a reduced capacity” if she had an accident.
Other members of the woman’s family, including her ex-husband and a cousin, backed up the daughter’s statement.
A consulting doctor said that the woman did not show any signs of pleasure from the company of her loved ones and seems to have very little, if any, understanding of what was going on around her. He added that “if she is able to perceive her present situation, that would make it even more painful”.
Mrs Justice Pauffley cited Section 1(5) of the Mental Capacity Act 2005 which states that any decision made on behalf of someone incapable of doing so themselves “must be done, or made, in [their] best interests”.
The judge said that while there is a “strong presumption in favour of the preservation of life” in these cases, they do not take priority over the patient’s best interests “as the paramount consideration for the court”.
She concluded by saying she was “left in no doubt as to where [the woman]’s best interests lie”, and ruled that it was not for a feeding tube to be reinserted. She declared it was lawful for the doctors to stop in their attempts to feed the woman through this, or any other, method.
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