An NHS Trust v AF & Anor

An NHS Trust v AF & Anor

The court found that the failure of the PEG tube and AF's recent pneumonia constituted material changes in circumstances requiring a new best interests evaluation. There was no evidence to undermine previous findings that AF derived pleasure and satisfaction from life and that his past wishes about not being kept alive as a 'body in a bed' did not apply to his current condition. Medical evidence indicated that PEG re-insertion was a low-risk, beneficial procedure likely to restore AF to his prior condition. The court concluded it is in AF's best interests to have the PEG re-inserted and to receive active treatment for pneumonia.

Parties
Applicant: AN NHS Trust; First Respondent (by His Litigation Friend, the Official Solicitor): AF; Second Respondent: SJ
Jurisdiction
England and Wales
Judgment Date
09 November 2020
Procedural Posture
Court of Protection Mental Capacity / Application for Declaration Regarding Best Interests and Medical Treatment
Outcome
Application granted
Legal Topics
Best Interests, Clinically Assisted Nutrition and Hydration (canh), Medical Treatment of Incapacitated Adults, Section 15 MCA 2005 Declarations
Mental Capacity Law Health Law Best Interests Clinically Assisted Nutrition and Hydration (canh) Medical Treatment of Incapacitated Adults Section 15 MCA 2005 Declarations

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Parties

AN NHS Trust

Applicant

AF

First Respondent (by His Litigation Friend, the Official Solicitor)

SJ

Second Respondent

Procedural Posture

Court of Protection Mental Capacity / Application for Declaration Regarding Best Interests and Medical Treatment

Legal Issues

  1. 1 Whether it is in AF's best interests to have a PEG tube re-inserted
  2. 2 Whether it is in AF's best interests to receive active treatment for pneumonia

Ratio Decidendi

The court found that the failure of the PEG tube and AF's recent pneumonia constituted material changes in circumstances requiring a new best interests evaluation. There was no evidence to undermine previous findings that AF derived pleasure and satisfaction from life and that his past wishes about not being kept alive as a 'body in a bed' did not apply to his current condition. Medical evidence indicated that PEG re-insertion was a low-risk, beneficial procedure likely to restore AF to his prior condition. The court concluded it is in AF's best interests to have the PEG re-inserted and to receive active treatment for pneumonia.

Court Disposition

Application granted

Orders

  • It is declared lawful and in AF’s best interests to undergo re-insertion of a PEG tube and any necessary ancillary procedures, subject to medical fitness and clinical indication as determined by his treating gastroenterology team.
  • It is in AF’s best interests to undergo active treatment for his current chest infection, including intravenous antibiotics and repeat blood tests.