Namiq v Manchester University NHS Foundation Trust [2020] EWCA
Readers of this blogger’s generation will already know that the answer to the Meaning of Life is 42. The Court of Appeal have now addressed a question too momentous for even Douglas Adams to tackle – what is the meaning of death?[1]
Last month in Manchester University NHS FT v Midrar Namiq (a minor) and others [2020] EWHC 6 (Fam) Lieven J was asked to consider the heart-rending issue of whether ventilation should be withdrawn from a severely brain injured baby (see our related blog here).
The Supreme Court had already confirmed in a number of appeals (including those launched on behalf of both Charlie Gard and Alfie Evans), that the Judge must apply the best interests tests in serious medical treatment cases. However, here the Trust’s position was that the child was in fact already dead and that there can be no best interests assessment of a person who is no longer legally alive. Hence, said the Trust, the Court’s function in Midrar’s case was to assess whether the relevant clinical testing had established that he was brain stem dead. In contrast, in addition to arguing that the brain stem testing had not been properly carried out, Midrar’s parents argued that the Court’s role was to apply the best interests test to the question of whether the intensive care support that was still keeping oxygenated blood circulating his body should be removed.
One difficulty was that, despite clinicians and paramedics regularly declaring life to be extinct, there is no legal definition of death in any statute. Death is clinically and not legally defined. Although the common law position was considered in 1993 when the House of Lords reviewed the position of Tony Bland who had been in PVS for three years after being caught in the Hillsborough crush. Although Tony Bland had no consciousness his brain stem was still functioning, which controlled his heartbeat, breathing and digestion, and as such, said their Lordships, he was not dead. Indeed, the medical consensus that death was to be diagnosed by an absence of brain stem function was expressly endorsed in Bland[2].