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CPR ruling if mother of eight in vegetative state stops breathing

Mr Justice Keehan says it is too soon to make a do-not-resuscitate decision after analysing evidence at a Court of Protection hearing.

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Court of Protection

Doctors should try to resuscitate a mother of eight who fell into a vegetative state after suffering a cardiac arrest less than two months ago, if she stops breathing, a judge has ruled after a hearing in a specialist court.

Specialists caring for the woman, who is in her 60s, wanted Mr Justice Keehan to rule that performing cardiopulmonary resuscitation (CPR) would not be in her best interests.

They said CPR would be futile and unnecessarily burdensome for her.

But Mr Justice Keehan on Thursday rejected an application by hospital bosses after the woman’s children raised objections and said she should be given a chance to make a recovery.

He said it was too soon to make a do-not-resuscitate decision.

The judge said a time might come when CPR would not be in the woman’s best interests, but that stage had not yet been reached.

Mr Justice Keehan had analysed evidence at a hearing in the Court of Protection, where judges consider issues in relation to  people who lack the mental capacity to make decisions, in London.

The judge said bosses at the University Hospitals Birmingham NHS Foundation Trust had made the application.

He said neither the woman nor her location could not be identified.

Doctors told Mr Justice Keehan how the woman had lost consciousness after suffering a cardiac arrest in July.

She had been diagnosed as being in a vegetative state.

Experts said she could not be diagnosed as being in a permanent vegetative state until six months had passed.

Specialists overseeing her care said she was immobile and bed-bound and needed “24/7” nursing care.

She could not communicate and specialists said there was no evidence that she was aware of her surroundings.

They said she opened her eyes and occasionally responded to pain.

She would remain bed-bound and specialists said it was “vanishingly unlikely” that she would be able to live outside a “24/7 nursing environment”.

They also said it would be wrong if the woman’s life  ended during CPR, and distressing for relatives.

But the woman’s children said she should be given a chance to make a recovery.

They said she held strong religious beliefs and would have wanted CPR.

An independent medical expert, not involved in treating the woman, also said it was too soon to rule out resuscitation.

Mr Justice Keehan said he understood arguments put forward by doctors caring for the woman.

But he said he had to take into account the “wishes and feelings” the woman had previously expressed to family members.

He said it was “plain” that she would have wanted CPR had she been able to make the decision.

“At the moment it remains in her best interests for this treatment to be provided to her,” he said.

“There may come a time when it is no longer in her best interests.”

But he added: “That stage has not been reached yet.”

Barrister John McKendrick QC had outlined arguments on behalf of the trust.

Nageena Khalique QC had represented the woman’s children.

The woman had been represented by staff from the office of the Official Solicitor, who provide help to people who lack the mental capacity to make decisions.

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