Lesley Barnor Townsend v Epsom and St Helier University Hospitals NHS Trust [2026] EWCA Civ 195 concerned a man who collapsed after suffering a severe stroke, never regaining consciousness, and who died on the morning of the hearing.
His doctors had concluded there was no prospect of him regaining consciousness nor recovering any quality of life. His family disputed this, believing him to be showing signs of responsiveness such as squeezing his wife’s hand, reacting to music and blinking on request, and asked that he continue to be given dialysis treatment for a kidney condition.
After further medical complications took place, his doctors made a ‘clinical decision’ to decline long-term treatment or continuous renal replacement therapy on the basis it would be ‘futile’ and ‘clinically inappropriate’, without referring the case to the Court of Protection. The case centred on whether they had followed the correct procedure when making this decision, given the man lacked capacity. His eldest daughter brought a legal challenge.
Allowing the daughter’s appeal, Lord Justice Baker held ‘the judge erred in holding that a clinical decision to withhold life sustaining medical treatment is not subject to best interests considerations and hence is not subject to the supervision of the courts’.
Instead, the trust should have referred the dispute without delay to the Court of Protection.
Baker LJ said: ‘Any decision about the care and treatment of a mentally incapacitated adult, including the withdrawal of life-sustaining treatment, must be taken in the patient's best interests. There is no carve out for “clinical decisions”.
‘The hospital cannot pre-empt court proceedings by unilaterally withholding or withdrawing treatment on “clinical” grounds. A decision whether or not to withdraw treatment has to be a best interests decision.’
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