UK Court Rules Hospital Acted Unlawfully in Withdrawing Treatment
The Court of Appeal in the UK has determined that a hospital unlawfully withdrew life-sustaining treatment from a 68-year-old man, Robert Varner, without obtaining court permission. This decision emerged from a family dispute over his care.
On March 3, the judges—Lord Justice Newey, Lady Justice Asplin, and Lord Justice Baker—concluded that the Epsom and St Helier University Hospitals NHS Trust acted outside the law when it ended Varner’s dialysis treatment on February 11, which they labeled as a “clinical decision.”
The court highlighted the process for such a serious decision. If there’s a disagreement about halting treatment for a patient who cannot decide for themselves, it must go through the Court of Protection, as laid out in the UK’s Mental Capacity Act. This act outlines how to navigate decision-making for those unable to advocate for their own care.
Baker emphasized that hospitals can’t bypass legal procedures by unilaterally stopping treatment for supposed clinical reasons. Discontinuing treatment, according to him, should always be in the patient’s best interests, rather than categorized purely as a clinical choice.
Varner passed away on February 27, shortly after the Court of Appeal had permitted his daughter, Leslie Varner Townsend, to contest the hospital’s decision. They had sent the case back for an emergency hearing, but unfortunately, the ruling came too late. Varner had been hospitalized since April after suffering multiple strokes that resulted in irreversible brain damage. His family noted that, despite his condition, he exhibited signs of responsiveness, such as following movements and reacting to music.
The court disclosed that the NHS trust had solicited opinions from three medical experts regarding Varner’s treatment. However, while two reports aligned with the notion of second opinions, one—by Professor Lynne Turner Stokes—was criticized for not being a true second opinion since it didn’t involve a direct examination of Varner.
A visit by the family on February 6 revealed that the medical team considered Varner unsuitable for long-term dialysis. Shortly after, on February 11, the trust’s legal representatives announced that they would cease to provide this essential treatment, justifying their position by labeling it a clinical decision exempt from legal oversight.
Townsend subsequently attempted to take the case to the Court of Protection, but her request was initially rejected on February 17, leading her to appeal a couple of days later. The case was ultimately heard on February 23, resulting in approval for her application and a directive for an urgent hearing.
The Court of Appeal clarified that while doctors are not obligated to provide treatment deemed clinically inappropriate, any disputes regarding withdrawal of life-sustaining care must be approached as an issue of the patient’s best interests as dictated by the Mental Capacity Act.
A spokesperson for the NHS trust expressed condolences to Varner’s family during this difficult period. Townsend stated her hope that the judgment would serve to protect other families encountering similar dilemmas, despite the realization that it was too late for her father.
She noted, “The system that took him must be held accountable.” Andrea Williams, the CEO of the Christian Legal Center that supported the family, called for an extensive public inquiry into end-of-life care in the UK. She argued for the necessary reforms to safeguard the sanctity of life within the healthcare system.
