Judge rules that ill man should be allowed to die

Judge rules that man in his 30s should be allowed to die because he does not want to live with a stoma

• Seriously ill patient who has long-term bowel problems made clear his wishes 
• Following surgery, specialists put chances of survival between 60 and 70%
• The man had lived with a temporary stoma before and ‘hated it,’ his parents said
• Man said: ‘How can I get a job? How can I get a woman?’ according to mother

Mr Justice Hayden published the ruling yesterday allowing the man to die

A judge has ruled a sedated man in his 30s should be allowed to die rather than live the rest of his life with a stoma.

The seriously ill patient who has suffered long-term bowel problems made clear his wishes before going into intensive care at Barnsley Hospital.

Following major surgery, specialists put his chances of survival between 60 and 70 per cent.

But they said he would need a permanent stoma – a surgical opening on the abdomen though which urine or faeces can be diverted out of the body.

The man had lived with a temporary stoma before and ‘hated it,’ his parents, who respect their son’s wishes, told Mr Justice Hayden during Monday’s Court of Protection hearing.

Speaking via videolink, his mother described how her son said: ‘How can I get a job? How can I get a woman?’    

In a ruling published yesterday, the judge was told the man had made a written ‘advanced decision’ saying he would not want to live with a permanent stoma.

It is unlikely to be appealed as none of the litigants opposed carrying out the man’s wishes. 

Bosses at Barnsley Hospital NHS Foundation Trust, who have responsibility for his care, had asked Mr Justice Hayden to decide what was in the man’s best interests.

They said a decision needed to be made because it would be some time before the man regained the capacity to make a decision for himself. 

The man had lived with a temporary stoma before and ‘hated it,’ his parents, who respect their son’s wishes, told Mr Justice Hayden during Monday’s Court of Protection hearing

Mr Justice Hayden considered evidence on Monday at a virtual hearing in the Court of Protection, where judges consider issues about people who lack the mental capacity to make decisions for themselves.

He outlined his decision in a written ruling published on Wednesday.

The judge said medics could lawfully stop providing nutrition and hydration by artificial means to the man and move him to a palliative care regime.

What is a stoma? 

A stoma is where a section of bowel is brought out through an opening on your stomach area (abdomen). Your bowel movements (excrement) are collected in a pouch or bag attached to the skin around your stoma. 

There are two types of stoma – a colostomy is formed from the large bowel and an ileostomy is formed from the small bowel.

Ileostomy is an opening from your small bowel to allow faeces to leave your body without passing through your large bowel. Bowel movements after an ileostomy are usually quite fluid.

Colostomy is an opening from your large bowel to allow faeces to leave your body without passing through your back passage (anus). Bowel movements after a colostomy are usually quite solid.

Source: Bupa 

Mr Justice Hayden said the man could not be identified in media reports of the case and referred to him by the initials ‘MSP’ in his ruling.

The man’s parents spoke to the judge at Monday’s hearing from their home, telling him their son had lived with a temporary stoma once before, following surgery.

‘He hated it,’ the man’s mother told the judge. ‘He said, ‘How can I get a job? How can I get a woman?’

‘We support what he wants.’

Mr Justice Hayden said many people live ‘perfectly full lives’ with a stoma, but the man had delivered a ‘consistent’ message.

‘Many people require a stoma to be fitted and I have no doubt that the vast majority make the necessary accommodations to ensure that it does not unnecessarily inhibit their enjoyment of life or become an impediment to their personal and sexual relationships,’ said Mr Justice Hayden in his ruling.

‘However, this was simply not the case with MSP. There is powerful evidence that as a young man in his 30s… MSP could never accept life with a stoma.

‘No amount of support, love or understanding could change MSP’s mind.

‘There is no doubt in my mind that he had come to a clear and entirely settled decision that he was not prepared to contemplate life with a stoma.’

The judge said the man had endured a ‘decade of serious ill health’ and had a ‘desperately reduced’ quality of life.

‘His confidence and self-esteem has been adversely impacted,’ said the judge.

‘His capacity to forge and maintain interpersonal relationships has been significantly eroded.

‘He has made a practical, utilitarian calculation that life in these circumstances is not what he wants.

‘In a real sense this is not a case about choosing to die, it is about an adult’s capacity to shape and control the end of his life.’

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