Judge rules that patient in coma for 6 months should be put into palliative care

August 8, 2023 Michael 0 Comments

Hillingdon Hospitals NHS Foundation Trust v IN & Ors [2023] EWCOP 32 (21 July 2023)

Read the full judgment

The person who is subject of these proceedings is IN, a 55 year old man originally from Romania who has lived in England for many years… On 29 December 2022 IN was driving when he suffered a severe pontine haemorrhagic stroke leading to a cardiac arrest and hypoxic brain injury. He has been in a coma for over six months. Brain scans show that his brain has atrophied globally. He is currently cared for at Hillingdon Hospital where he is receiving care including Clinically Assisted Nutrition and Hydration (CANH). [1]

The Applicant Trust… considers that the IN’s coma is irreversible and there is no prospect of recovery such that further treatment is futile and will bring him no benefit. It maintains that the burden of continuing CANH cannot be justified as being in IN’s best interests and invites the Court to make declarations and orders that it would be lawful to withdraw CANH and for IN to receive palliative care only. It is likely that within a week or so of withdrawing CANH, IN will die. [2]

IN’s family… oppose the Trust’s application. They do not dispute the medical analysis but contend that IN would have wanted CANH to continue so that he could be kept alive for as long as possible. He was a “fighter” whose Christian faith would have led him to believe that God might perform a miracle to bring him back to consciousness and a fuller life. [5]

Main Conclusion

This is a case in which the presumption that life should be preserved is displaced by the weight of countervailing factors, most particularly the very profound brain damage which has left IN in a permanent coma from which he is highly unlikely to emerge even to a vegetative state, the inability to experience pleasure, the burdens of his condition and continued treatment and the absence of any prospect of improvement. I do not find it possible to ascertain IN’s own wishes and feelings. His values and beliefs may or may not have led him to decide to continue CANH had he retained capacity. The views of his family members about his best interests and his values and beliefs weigh in favour of continuing CANH, but not to the extent that they outweigh the other factors supporting the withdrawal of treatment. [41]


I gave this judgment in open court on 21 July 2023. Very sadly IN died in hospital on 24 July 2023. This was before the implementation of the plan to withdraw CANH. I have offered my condolences to his family who raised no objection to this judgment to be published.

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Judge rules that patient in coma for 6 months should be put into palliative care was last modified: August 8th, 2023 by Michael

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