Saturday, May 7, 2016

Court Rules for Clinicians in Medical Futility Conflict with Parents




Mr Justice Cobb

The UK courts have published the latest in a long line of written judgments in medical futility cases.  County Durham & Darlington NHS Trust Foundation v. SS.  This, like most of these cases, was in favor of the NHS.



PATIENT

SS is a 7-year-old girl.  She is critically frail.  SS is profoundly neurologically disabled with encephalopathy and microcephaly.  She has advanced scoliosis of her spine, putting her at serious risk of respiratory failure.  She has thin osteopaenic bones.



CLINICIANS

The clinicians sought the court's permission as follows: 



"(1) Notwithstanding the lack of consent of the father and mother, it is lawful and in the best interests of the child [that] medical practitioners . . . shall be at liberty to treat her in accordance with their clinical discretion, including any decisions they make whether or not to resuscitate her in the event of her suffering a collapse."





"(2) The Applicant's staff shall generally provide such treatment and nursing care as may be appropriate to ensure that S suffers the least pain and distress and retains the greatest dignity."



PARENTS

The parents opposed the clinicians' plan.  But the court questioned both their capacity and their level of involvement with SS. 



COURT

In addition to hearing from the clinicians and parents, the court obtained two "truly independent" views.  Ultimately, the court's objective best interest analysis determined that "any perceived benefit" is "significantly outweighed" both by the burdens of treatment and by "the considerably compromised situation in which she will be left."


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