Medical treatment

TH was a 52-year-old man in a minimally conscious state at the lower end of the spectrum of that condition. The applicant NHS Foundation Trust sought authority to provide, in the exercise of its clinical discretion, life-sustaining treatment. The second respondent, TH’s ex-wife and long-term partner, contended that TH wished to die as quickly and painlessly as possible. A professor of neurological rehabilitation highlighted the benefits of the standard assessment tool, sensory modality assessment and rehabilitation technique (SMART).

The court held that, in relation to the withdrawal of nutrition and hydration, the correct course was to adjourn the issue to provide for a structured clinical assessment to evaluate whether there was evidence that TH’s primary neurological pathways were sufficiently intact to permit any evidence of awareness to be detected and fully to assess, over a set period of time, TH’s general awareness, responsiveness and capacity to experience pain. The structured assessment contemplated by SMART would give the best