Religion plea rejected in life-support court case

London, England - The high court in London yesterday upheld the right of the NHS to withdraw life support systems from a critically ill 86-year-old man who is considered by doctors to have no chance of getting better.

His Muslim family appealed to the court to block the decision on the grounds that their religious beliefs required doctors to do everything in their power to keep their father alive. Only God had the power to bestow death, they said.

But Mr Justice Kirkwood said the family's evidence and beliefs were outweighed by an overwhelming consensus of doctors who had looked at the man's medical condition.

He granted the NHS trust, which also cannot be named for legal reasons, the declarations it sought to allow it to withdraw ventilation and dialysis. But he told the doctors to delay acting on this decision until midday on Tuesday to give the family time to seek permission to appeal.

The case raised a big ethical and legal issue about whether doctors' opinion that a patient should be allowed to die in dignity should take precedence over contrary views of the patient and their family.

Vivienne Nathanson, the head of ethics at the British Medical Association, said last night: "It would be extremely unusual, if a patient wants treatment that is sensible and rational for the [medical] condition, for that treatment not to be given."

The 86-year-old - known as Mr A - was born in Pakistan and fought for Britain inthe second world war. He was a "strong, active man" until suffering a heart attack in July this year, after which he rapidly deteriorated and is now being kept alive by life support systems and regular life-saving operations.

The NHS trust that runs the hospital where he is resident told the court he had no chance of getting better and asked for the right to withdraw life support and let him die.

But this was disputed by his family in Scotland, who said they had a doctor's evidence that their father was getting better.

The judge described how Mr A had been "a tall, strong, active man and a devout Muslim endowed with courage and wisdom", until he suffered a heart attack when on a visit to his homeland in Pakistan last month.

After he returned to Britain his condition deteriorated and he is now in intensive care, having contracted an MRSA infection, with system failure affecting all his major organs, being kept alive by machines.

One of the man's sons had told the judge earlier in the hearing that according to the Islamic faith it was imperative for doctors to protect life.

"If the available medicine can protect life then it must. Death is in the hands of God. Any withdrawal of life support would be tantamount to murder," he said.

Robert Glancy QC, for the family, presented the court with evidence from a doctor who had examined the patient and supported the family's belief that their father was getting better.

The doctor, known as Dr R, said the 86-year-old - who had already defied experts by surviving when ventilation was taken away from him on August 16 - had a chance of recovering to the extent that he could live at home with medication to control his ailments, should he be nursed into recovery from his current crisis. But the judge preferred the evidence of the other doctors.

"It doesn't seem to me that the doctor had any evidence of [improvement]. The evidence of all the other doctors of continued deterioration is preferred," he said.

"I'm satisfied that Mr A has significant impairment of his major functions and that Mr A is dying. Medical science shows no sensible chance of recovery.

"The natural process of dying is being extended only by life support interventions and they are not improving the underlying causes of Mr A's condition.

"Mr A is sentient to the extent that he is aware of pain and discomfort and intrusions upon his personal dignity.

"It is in his best interests that he be allowed a peaceful and dignified death.

"Everything should be done to support him in that, including hydration and nutrition, but it's not in his best interests that he should continue to be subjected to painful and undignified medical processes which do nothing to improve his terminal condition."

The judge said he recognised how difficult it was for the man's loving family to accept the medical evidence that their father's life was drawing to a close.

His decision means doctors can now legally refuse to resuscitate Mr A should he suffer cardiac or respiratory failure, and can withdraw blood filtration services from him, although they will continue to provide him with nutrition and hydration.

Mark McGee, the family's solicitor, told Channel 4 news last night: "They see it as their moral and religious duty to bring the case to court and resist [the trust's decision] as much as possible."