Best interests and withdrawal of CANH—who decides and what are the key factors to be considered? (University College London Hospitals NHS Foundation Trust v PK & Another)
Private Client analysis: The Court of Protection determined that it was in the best interests- as defined in s4 Mental Capacity Act 2005 (MCA 2005)—for a 73 year old man (PK) who had suffered from a stroke and had other health problems and who lacked capacity, to continue to be fed by clinically assisted nutrition and hydration (CANH) via a nasogastric tube in a hospital. The Foundation Trust had applied for a declaration- with which PK's family disagreed—that the tube should be removed. The tube needed significant maintenance. The benefits—prolonging his life, allowing him to interact with his family and respecting his religious beliefs, outweighed the burdens; PK being in some pain, the extended time in which he had been in hospital bedbound and that he was unable to comprehend what was happening to him. There were also concerns about the environment required for CANH to continue—unfamiliar people appearing and sensory challenges- and the burdensome nature of intimate care for some of the treatment. Written by Julia Abrey, Consultant at Withers LLP.