EWJ August 62 2025 web - Journal - Page 113
Life, Dignity and Belief: Court Refuses to
Authorise Withdrawal of Feeding in
UCLH NHS Trust v AB [2025] EWCOP 16
Article by Khadim Al’Hassan - www.parksquarebarristers.co.uk
Key factors include:
l The person’s past and present wishes and feelings
Read the full judgment here: [2025] EWCOP 17 (T3)
This judgment serves as a sobering reminder that
decisions about life and death are not purely medical.
They are, at their core, human judgments—rooted in
respect for the individual’s voice, their beliefs, and
their dignity as they define it.
l The beliefs and values that would likely influence
their decision
l The views of those close to the person
l Medical evidence concerning prognosis, pain, and
quality of life
In a deeply sensitive and ethically complex judgment,
the Court of Protection in UCLH NHS Trust v AB
[2025] EWCOP 16 declined an application by an NHS
Trust to permit the withdrawal of clinically assisted nutrition and hydration (CANH) from a 73-year-old
man, PK, who had suffered a serious stroke. The
Trust argued it was no longer in PK’s best interests to
continue life-sustaining treatment due to his minimal
consciousness and multiple health complications.
However, Mr Justice McKendrick ruled that continuing CANH was indeed in PK’s best interests, having
carefully weighed medical evidence, the views of his
family, and above all, PK’s own values and religious
beliefs.
Key Submissions and Arguments:
1. The Trust’s Position:
Continued treatment prolonged suffering without
any realistic hope of recovery.
PK was largely unaware of his surroundings.
Maintaining life artificially was burdensome and no
longer aligned with dignity or humane treatment.
Medical professionals believed that PK would not wish
to continue in such a condition, despite not knowing
him personally.
1. AB and Family’s Position:
Factual Background:
PK was a 73-year-old man of devout Islamic faith. He
suffered a severe stroke in 2020, leaving him with profound physical disabilities, limited speech, and dependent on a feeding tube. He was later diagnosed
with vascular dementia, further affecting his mental
capacity.
PK had consistently expressed strong religious beliefs
affirming the sanctity of life.
He had never supported any form of assisted dying or
intervention to shorten life.
There was still some evidence of awareness and
connection—PK reacted to voices and smiled at
family members.
The NHS Trust sought court permission to withdraw
feeding, arguing that PK lacked capacity and that his
quality of life had become so diminished that continued treatment served no beneficial purpose. The
Trust pointed to medical evidence suggesting that PK
was largely unresponsive, doubly incontinent, immobile, and at times distressed. They contended that to
continue life in such a condition amounted to a denial
of dignity.
Withdrawing feeding would actively shorten his life,
contrary to his values and those of his family.
Court’s Reasoning and Judgment:
Mr Justice McKendrick undertook a meticulous analysis of both the medical and personal evidence. His
key findings included:
l PK Lacked Capacity: The judge accepted that PK
did not have the mental capacity to decide on treatment due to his dementia and cognitive impairment.
l Evidence of Consciousness and Response: Despite
his impairments, PK showed some signs of awareness,
such as reacting to his name, smiling at familiar voices,
and responding during religious recitations.
AB, PK’s daughter and litigation friend, opposed the
application. She stated that PK, a devout practising
Muslim, believed strongly in the sanctity of life. She referred to his expressed views in earlier years, including
during his time caring for his ill wife, when he had opposed euthanasia and expressed that life should be preserved until its natural end. PK’s family, including his
sons, also supported the continuation of feeding.
l Weight to Past Beliefs: The court gave significant
weight to PK’s known religious convictions. Justice
McKendrick quoted from PK’s daughter, who said,
“My father believes only God can decide when life
should end.” This religious belief, deeply held and
clearly expressed during his life, was seen as central
to understanding what PK would have wanted.
Legal Framework:
The application fell under the Court of Protection’s
jurisdiction to make decisions under the Mental Capacity Act 2005, particularly section 4, which requires
the court to determine what is in the person’s “best
interests”.
EXPERT WITNESS JOURNAL
111
AUGUST/SEPT 2025
