Judge rules woman paralysed after contracting Covid should be allowed to die

A grandmother in her 50s who was at the centre of a life-support treatment dispute as a result of being left brain-damaged and paralysed from the neck down after contracting Covid-19 should be allowed to die, a judge has ruled.

Specialists treating the woman – who cannot speak and is on a ventilator – at Addenbrooke’s Hospital in Cambridge said life-support treatment should end. The woman’s relatives disagreed and said she should be given more time.

Mr Justice Hayden had considered evidence at a recent trial in the Court of Protection, where judges oversee hearings centred on adults who lack the mental capacity to make decisions, in London.

He delivered a ruling on Friday and concluded that life-support treatment should stop by the end of October.

Specialists had told the judge that the woman was the “most complicated” Covid-19 patient in the world.

The judge, who heard evidence from the woman’s adult children and sister, said she had “profound complications”.

Doctors said there was nothing they could do to make “any aspect of her condition better” and that life-support treatment was causing her distress and adding to her “burden”.

They thought that her life expectancy could be measured in months and said moving her to a palliative care regime would enable her to die peacefully and without distress.

Mr Justice Hayden said it was the first time a judge had considered an end-of-life case as a result of Covid-19.

He heard how the woman, who was overweight and had underlying health problems, went into hospital with symptoms of Covid-19 late in 2020.

Barrister Katie Gollop QC, who represented hospital bosses, said the woman’s case appeared to be “unique”.

She said the woman was “almost entirely paralysed” and had “severe” cognitive impairment.

One specialist said the woman had complications not “described” in the UK before.

The judge named Addenbrooke’s Hospital, and its governing trust, the Cambridge University Hospitals NHS Foundation Trust, in a written ruling.

But he said the woman could not be identified in media reports of the case.

Trust bosses had begun litigation and asked him to decide what moves were in the woman’s best interests.

Ms Gollop said specialists thought there were two choices.

They could continue to treat the woman in an intensive care unit until she “succumbs to a fatal infection”, at an “unpredictable time”, when there may be “no family in attendance”.

She said the second option was that the woman should move to a “calm, quiet and private place”, where her life could come to a close when she was “surrounded” by the love of her family.

Mr Justice Hayden ruled that ventilation should be discontinued by the end of October and said it would be in her best interests to move “to a place which protects her privacy and affords her greater rest”.

He said it was not in her best interests that ventilation should continue “indefinitely”. However, he said ventilation should continue until her children and family members could be “with her”.

He said such a plan would give a “close and loving family” a chance to be “together at the end”.

The trust’s medical director Dr Ashley Shaw described the case as a “devastatingly sad situation”.

“This is an exceptionally rare condition including catastrophic and irreversible brain damage, and our doctors have explored every medical treatment,” he said after the ruling.

“Independent medical experts and a highly-experienced Court of Protection judge agree with our teams that further treatment, to prolong life beyond a reasonable time for the patient to be with their family, would be futile and would only extend the patient’s suffering.”

He added: “We will continue to work closely with the family to meet their needs, as well as the needs of their loved one.”

Mr Justice Hayden referred to the woman by the initials “AH” in his ruling and said he had visited her in hospital.

“The impact of this insidious virus upon AH has been brutal,” the judge said in his ruling.

“I have been told, authoritatively, that in terms of the neurological impact and complications AH is ‘the most complex Covid patient in the world’.

“This conclusion was arrived at following consideration of both national and international case studies.

“On any view, the evidence in this case is extremely challenging. None of the available options is devoid of difficulty.

“The impact of this virus on AH has created an invidious dilemma both for her family and for the professionals caring for her.”

He said it was imperative that a decision was taken about where the woman’s best interests lay.

But he said there was “no solution” which was “in any way comforting”.