UCLH

LIFE-SAVING treatment to a patient severely disabled after a catastrophic stroke was continued after court ruled he was still showing signs of consciousness – including raising a smile whenever anyone mentioned Arsenal.

Experts at University College London Hospitals had described the 73-year-old as unable to communicate verbally, unable to eat without a feeding tube and with “almost no muscle mass”.

The NHS trust had sought court permission to stop his treatment, arguing his quality of life had become so poor treatment would not be of any benefit to him and he lacked capacity to make decisions for himself.

But an application to stop feeding and hydrating the man, known as PK, by clinicians at University College London Hospitals was rejected by the Court of Protection.

But Mr Justice Mckendrick ruled: “I accept the clinical evidence [that] there will, in all likelihood, be no improvement from the stroke, but it does not follow from that, that his treatment is futile.”

The judgment noted how consultant neurologist, Gerolemos Christofi had found evidence of consciousness.

The evidence said: “He was able to undertake single-stage commands without being prompted to copy tasks. He smiled when I mentioned his football team (Arsenal).”

The judgment said PK “was able to stick out his tongue when asked to do so and mouthed unintelligible words in response to questions”, while accepting his “ability to engage is variable and limited by excessive cognitive, physical fatigue and frailty”.

He concluded “PK is conscious of himself and of his external environment”.

PK was had been brought up surrounded by violence in a country in East Africa, coming to this country in 1993.

He suffered a severe stroke in 2020 and was later diagnosed with dementia.

Devoutly religious, he could recite the Qur’an and was a very hands-on father according to his daughter who had told of his strong belief in the sanctity of life.

The judgment said: “He has expressed strong views about dying. In the summer of 2024 she watched a TV programme about assisted dying with him and says he was confused that anyone would want to prematurely end their life, even if in pain or suffering from disability. He turned to his daughter and said: ‘Only God decides when you die’.”

The family’s lawyers had said: “The court gave significant weight to PK’s known religious convictions. This religious belief, deeply held and clearly expressed during his life, was seen as central to understanding what PK would have wanted.”

The evidence had said that the application to remove the feeding tube was in no way a clinical act to hasten his death but about “not prescribing a current treatment that has ceased to be of benefit”.

UCLH did not respond in time to a request from the New Journal for comment.

But the judgment outlined the NHS trust’s position as: “The applicant’s position in summary is that there are greater burdens than benefits to the ongoing treatment and as a result the [feeding] tube should be removed as it is no longer in PK’s best interests.”

The judge said the UCLH’s lawyers had “emphasised the fact PK is nil by month and that he experiences pain every day”, adding: “Very appropriately he began his submissions by paying tribute to the dignity of PK’s family.”

A UCLH spokesperson said: “We welcome the clarity of the judgment and acknowledge these are incredibly difficult circumstances for the family. We will continue to work with them to support and care for PK.”