England and Wales Case Law

The Hillingdon Hospitals NHS Foundation Trust v YD & Ors (Refusal of Withdrawal of Treatment)

The Hillingdon Hospitals NHS Foundation Trust v YD & Ors (Refusal of Withdrawal of Treatment) [2025] EWCOP 31 (T3) (12 August 2025)

Court of Protection held that CANH should continue for a man in PDOC, finding his spiritual beliefs, wishes and values outweighed the medical case for withdrawal.

• Withdrawal of clinically assisted nutrition and hydration (canh)
• Best interests
• Prolonged disorder of consciousness (pdoc)
• Persistent vegetative state (pvs)
• Article 9 echr - freedom of belief
• Article 2 echr - right to life

Read case analysis

AB (ADRT: Validity and Applicability), Re

Subject to proof of authenticity and compliance with MCA 2005 s25(6), AB's ADRT is valid and applicable to his current circumstances: he is in a prolonged disorder of consciousness, unlikely ever to recover capacity or to a state not requiring full-time care, and is receiving life-sustaining treatment (CANH) which he expressly refused in his ADRT. There is no evidence of withdrawal, inconsistent conduct, or unanticipated circumstances that would affect the ADRT's effect. The remaining issue is whether the ADRT is authentic and made free from undue influence, which will be determined at a furt…

Source excerpt

• Advance decision to refuse treatment (adrt)
• Mental capacity act 2005
• Life-sustaining treatment
• Prolonged disorder of consciousness (pdoc)
• Validity and applicability of advance decisions
• Best interests

Read case analysis

AB, Re (ADRT: Validity and Applicability)

AB, Re (ADRT: Validity and Applicability) [2025] EWCOP 20 (T3) (10 June 2025)

The Court of Protection held that AB’s apparent ADRT is valid and applicable, subject to proof of authenticity and compliance with life-sustaining treatment formalities.

• Advance decision to refuse treatment (adrt)
• Validity of advance decisions
• Applicability of advance decisions
• Mental capacity act 2005
• Life-sustaining treatment
• Prolonged disorder of consciousness (pdoc)

Read case analysis

NHS South East London Integrated Care Board v JP & Ors

It is not in JP's best interests to continue to receive clinically-assisted nutrition and hydration (CANH). The treatment is futile, burdensome, and inconsistent with JP's values and wishes as reliably ascertained from his children and late partner. The medical evidence is clear that JP is in a permanent vegetative state with no prospect of recovery, and continued CANH would only prolong his current condition without benefit. The court is satisfied that withdrawal of CANH is lawful and appropriate.

Source excerpt

• Withdrawal of clinically-assisted nutrition and hydration (canh)
• Best interests decision
• Prolonged disorder of consciousness (pdoc)
• Permanent vegetative state (pvs)
• Human dignity

Read case analysis

NHS South East London Integrated Care Board v JP & Ors

The Court of Protection criticised prolonged delay in bringing JP’s CANH best-interests case, stressing prompt, patient-centred decision-making and proactive commissioner oversight.

• Withdrawal of clinically-assisted nutrition and hydration (canh)
• Best interests decision-making
• Prolonged disorder of consciousness (pdoc)
• Delay in medical decision-making
• Role of family in best interests
• Obligations of care providers and commissioners

Read case analysis

NHS South East London Integrated Care Board v JP & Ors

NHS South East London Integrated Care Board v JP & Ors [2025] EWCOP 8 (T3) (26 February 2025)

The Court of Protection held that there had been unacceptable delay in bringing JP’s best-interests case over CANH, and criticised both the hospital and ICB.

• Best interests
• Withdrawal of clinically-assisted nutrition and hydration (canh)
• Prolonged disorder of consciousness (pdoc)
• Delay in court applications
• Role of family in best interests decisions
• Institutional obligations

Read case analysis

NHS South East London Integrated Care Board v JP & Ors

NHS South East London Integrated Care Board v JP & Ors [2025] EWCOP 4 (T3) (24 January 2025)

Court of Protection decision holding that continued CANH for JP was not in his best interests and should be withdrawn.

• Best interests
• Withdrawal of clinically-assisted nutrition and hydration (canh)
• Prolonged disorder of consciousness (pdoc)
• Permanent vegetative state (pvs)
• End-of-life care
• Human dignity

Read case analysis