Vikram Sachdeva and Victoria Butler-Cole acted pro bono for the family of M, a 52 year old woman who suffered a brain infection in 2003 which had left her in a minimally conscious state. M’s family believed that, eight years on, M would not have wanted to continue to be kept alive in her state of severely reduced consciousness, and applied to the court for a declaration that it was in M’s best interests for artificial nutrition and hydration to be removed. This was the first case in England concerning a patient in a minimally conscious state, and has important consequences. Firstly, it clarifies that it is possible that withdrawal of ANH may be lawful in a particular case, although on the facts of M’s case, the judge concluded that it was in her best interests to continue to have ANH. Secondly, it reveals the serious problems that will be faced by relatives trying to achieve what they believe would have been the wishes of an incapacitated family member unless there is a formal written advance decision which can be relied on. Thirdly, the court emphasised that all cases of withdrawal of ANH for patients in a vegetative state or minimally conscious state must be decided by the Court of Protection, and set out guidance to be followed in the future.
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