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25th Apr 2024 | Cases
Nick Goodwin KC was instructed by the Applicant local authority in A Council v An NHS Foundation Trust & Ors [2024] EWHC 874 (Fam); an application by a local authority for leave to withdraw medical treatment from a child in care who had suffered severe brain damage.
Child Z was born prematurely, and with several serious medical issues, in April 2022. He was transferred to a children’s hospital very shortly after his birth where he remained. On 16 July 2023, Z’s tracheotomy tube became dislodged during a period when he was not being observed and this resulted in a cessation of his oxygen supply which led to severe brain damage. Z was subsequently admitted to the intensive care unit where he remained.
The evidence both from the paediatric consultant in the intensive care unit, but also reflecting the unanimous view of all his colleagues who were caring for Z, was that Z had no quality of life. The NHS Trust took the view that it was appropriate to move to a palliative care model.
Both parents were heroin addicts and the local authority (LA) were concerned about their capacity to give consent to end of life treatment for Z. The LA therefore brought this application for leave to invoke the inherent jurisdiction in relation to the withdrawal of medical treatment and the provision of end of life care in relation to Z who was made subject to a care and placement order on 4 October 2022.
The father did not have parental responsibility and although the mother had not undertaken a formal capacity assessment under the Mental Capacity Act 2005, the LA’s position was that she did have capacity to consent. The court was not convinced that the mother could be presumed to have capacity but did take into account that both parents had expressed the view that it was in Z’s best interests to allow him to move to palliative care. The ultimate decision, as to what was in Z’s best interests, lay with the court. Given the overwhelming medical evidence and united clinical view, the application was allowed.
Reported in Local Government Lawyer.