Right-to-life case adjourned after man shows signs of consciousness

Neurologist dramatically switches sides to support family after hospital visit

Terri Judd
Thursday 23 August 2012 23:02 BST
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Louise Thomas

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A family pleading for the right to keep their severely brain-damaged father alive received a startling 11th-hour fillip yesterday when a doctor confirmed there were signs of consciousness.

A case before the Court of Protection was adjourned when the family's claims that he was reacting to their presence, consistently denied by clinicians, were confirmed by a doctor who witnessed just such a response on Wednesday night.

"The family feel vindicated in fighting their case but even more importantly they are relieved that medically Mr L is no longer in a vegetative state and there is hope for recovery," said the family's solicitor, Helen Lewis, of Pannone. She added: "It is a sobering thought that the Trust would have put in place a 'do not resuscitate' order if the family had not challenged their stance through the legal system."

Just five weeks ago the 55-year-old, who can only be identified as Mr L, suffered a third cardiac arrest which left him severely brain-damaged, "awake but unaware", with his chances of recovery "exceptionally remote".

His wife and sons have been in the Court of Protection this week fighting an application by Pennine Acute Hospitals NHS Trust to implement a 'do not resuscitate order' if he suffers a "life threatening event".

Despite their assertions that during daily visits he had reacted by following them with his eyes and expressing emotion, doctors insisted these were simply the reflex movements of someone in such a vegetative state.

But yesterday, just as expert in neurology, Dr Peter Newman, was due to give evidence expected to support the Trust's application, the family's barrister, Jenni Richards QC, revealed Mr L had shown signs of consciousness the night before. She told Mr Justice Moylan that relatives had visited him in hospital along with a doctor, who produced a witness statement in which he accepted there was a "closing of eyes and grimacing" when Mr L's eyes were cleaned.

Ms Richards said: "That video footage was viewed this morning by Dr Newman as well as by representatives of the family... Dr Newman's view... was that Mr L was no longer in a persistent vegetative state." She said Dr Newman now felt Mr L was now "most likely in a minimally conscious state" and further improvement was possible.

The possibility could not be ruled out that he could develop "beyond the minimally conscious state, although of course the nature of his brain injury means he will always be severely incapacitated", said Ms Richards.

However, Claire Watson, appearing for the Trust, said it was unlikely the doctors would alter their care plane in light of medical evidence of the severity of his brain injury.

Mr L's family insist it is too soon to make the decision and, largely due to his strong Islamic faith, he would want to be resuscitated.

But one leading expert gave evidence that a clinician had to judge what quality of life he would have if resuscitated, whether it would be a "meaningful recovery" characterised by "pleasure, or discomfort and distress". He estimated the chances of making such a "meaningful recovery" as 1 in 10,000.

Yesterday the case was adjourned until 1 October for doctors to consider the new evidence about his condition. In the meantime, the judge ordered he should be resuscitated if life was threatened.

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