An NHS Trust v S & L (A Child) (Witholding Life Sustaining Invasive Treatment)

An NHS Trust v S & L (A Child) (Witholding Life Sustaining Invasive Treatment)

It is not in L's best interests to receive cardio-pulmonary resuscitation. It is lawful and in her best interests to receive basic intensive care support, including non-invasive mechanical ventilation, nutrition, and infection management, while there is a reasonable expectation of improvement to discharge. Invasive mechanical ventilation may be given for a time-limited trial if clinically indicated. If there is no reasonable expectation of improvement, it is lawful to move to a palliative care pathway. The court's decision is based on a holistic assessment of L's welfare, weighing the benefits of conscious interaction with her family against the burdens and futility of invasive treatment...

Parties
Applicant: A NHS Trust; Respondent Parents: Mr and Mrs S; Subject Child: L (a Child); Guardian for L: Children's Guardian (Miss Julian)
Jurisdiction
England and Wales
Judgment Date
10 November 2017
Procedural Posture
Inherent Jurisdiction (child Medical Treatment) / Interim Judgment and Final Declarations
Outcome
Declarations granted as to lawfulness and best interests regarding treatment limitations and palliative care.
Legal Topics
Best Interests of Child, Withholding/withdrawing Life Sustaining Treatment, Parental Responsibility, Inherent Jurisdiction, Palliative Care, Declarations of Lawfulness
Family Law Medical Law Children Law Best Interests of Child Withholding/withdrawing Life Sustaining Treatment Parental Responsibility Inherent Jurisdiction Palliative Care +1 more

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Parties

A NHS Trust

Applicant

Mr and Mrs S

Respondent Parents

L (a Child)

Subject Child

Children's Guardian (Miss Julian)

Guardian for L

Procedural Posture

Inherent Jurisdiction (child Medical Treatment) / Interim Judgment and Final Declarations

Legal Issues

  1. 1 Whether it is in the best interests of L (a child) to receive invasive life-sustaining treatment (mechanical ventilation, CPR) or to limit treatment to palliative care
  2. 2 Whether the court should make declarations authorising or prohibiting escalation of treatment

Ratio Decidendi

It is not in L's best interests to receive cardio-pulmonary resuscitation. It is lawful and in her best interests to receive basic intensive care support, including non-invasive mechanical ventilation, nutrition, and infection management, while there is a reasonable expectation of improvement to discharge. Invasive mechanical ventilation may be given for a time-limited trial if clinically indicated. If there is no reasonable expectation of improvement, it is lawful to move to a palliative care pathway. The court's decision is based on a holistic assessment of L's welfare, weighing the benefits of conscious interaction with her family against the burdens and futility of invasive treatment...

Court Disposition

Declarations granted as to lawfulness and best interests regarding treatment limitations and palliative care.

Orders

  • It is not lawful or in L’s best interests to receive cardio-pulmonary resuscitation.
  • It is lawful and in L’s best interests to receive basic intensive care support including non-invasive mechanical ventilation, nutrition, management of infection and temperature control whilst there is a reasonable expectation of her improving to discharge from a PICU.