Portsmouth NHS Trust v Wyatt and others: FD 7 Oct 2004

Charlotte Wyatt was born prematurely, and depended for day to day her life on medical support. Her doctors asked to be permitted not to resuscitate her again if she needed it. Her parents asked that she be given whatever chance was available for her to live.
Held: ‘On the basis of the unanimous medical evidence in this case, the issue in all probability is not whether this baby should live or die but how and when she should die.’ . . ‘What is the role of the court in all this? Any civilised society must have the means by which intractable disputes, whether between the state and the citizen or between citizens themselves are to be resolved. That is the purpose of the courts and the system of civil and family justice in this country. This kind of dispute is to be resolved by a Judge of the Family Division and whilst the judge will be more aware than anyone of his own limitations in deciding as profound an issue as this, decision there simply has to be. It may well be that an external decision is in the end a better solution than the stark alternatives of medical or parental veto. ‘ and ‘The court starts with the fundamental principles of the sanctity of life, the best interests of Charlotte which govern choice and her inherent right to respect for her dignity. Her parents say that all these point in the direction of renewed aggressive treatment in the event of further deterioration. The medical advice is that she should then be allowed to die peacefully in her parents’ arms if that is the natural course and that she should be supplied with all necessary palliative care. There is this common ground: that as and when she comes to die she should do so peacefully with her parents. . . Given that death is the one experience (other than birth) that all humanity must share, no view of life that does not include a contemplation of the place of death, even in a child, can be complete. As a society we fight shy of pondering on death yet inherent in each of us is a deep desire both for oneself and for those we love for a ‘good’ death. It seems to me therefore that in any consideration of best interests in a person at risk of imminent death is that of securing a ‘good’ death. It would be absurd to try to describe that concept more fully beyond saying that everyone in this case knows what it means – not under anaesthetic, not in the course of painful and futile treatment, but peacefully in the arms of those who love her most.’ and ‘I have given this case my most anxious and closest attention. I am only too aware of my own limitations in making so momentous a decision. Yet in the end I have come to a clear view. Subject to two observations that I wish to make at the end of this judgment, I do not believe that any further aggressive treatment, even if necessary to prolong life, is in her best interests. I know that that may mean that she may die earlier than otherwise she might have done but in my judgment the moment of her death will only be slightly advanced. I have asked myself: what can now be done to benefit Charlotte? I can only offer three answers: first, that she can be given as much comfort and as little pain as possible; secondly, that she can be given as much time as possible to spend physically in the presence of and in contact with her parents; thirdly, that she can meet her end whenever that may be in what Mr Wyatt called the TLC of those who love her most. Although I believe and find that further invasive and aggressive treatment would be intolerable to Charlotte, I prefer to determine her best interests on the basis of finding what is the best that can be done for her.

Hedley J
[2004] EWHC 2247 (Fam), [2005] 1 FLR 21, [2004] Fam Law 866, (2005) 84 BMLR 206
CitedIn re J (a Minor) (Wardship: Medical treatment) CA 1-Oct-1990
J was born at 27 weeks’, weighing only 1.1kg. He suffered very severe and permanent brain damage at the time of his birth, the brain tissue then lost being irreplaceable. He was epileptic and the medical evidence was that he was likely to develop . .
CitedRegina (Burke) v General Medical Council Admn 30-Jul-2004
The applicant, suffering a life threatening disease, wanted to ensure his continued treatment and revival in the circumstance of losing his own capacity. He said the respondent’s guidelines for doctors were discriminatory and failed to protect his . .
CitedIn Re S (Adult Patient: Sterilisation) CA 26-May-2000
The court should decide what is in the best interests of a patient where she was unable to give consent herself. The test of whether what was proposed was within the range of what reasonable and competent medical practitioners might propose, got the . .
CitedAiredale NHS Trust v Bland CA 9-Dec-1992
The official Solicitor appealed against a decision that doctors could withdraw medical treatment including artificial nutrition, from a patient in persistent vegetative state.
Held: The doctors sought permission to act in accordance with . .
FollowedRe A (Male Sterilisation) CA 2000
The court considered the duties of a doctor, asking whether a procedure should be undertaken for a patient without the capacity to consent: Dame Elizabeth Butler-Sloss said: ‘The doctor, acting to that required standard, has, in my view, a second . .
CitedIn Re J (A Minor) (Child in Care: Medical Treatment) CA 26-Aug-1992
. .
CitedIn Re A (Mental Patient: Sterilisation) CA 13-Jan-2000
The patient suffered from Down’s Syndrome. As his mother became unable to care for him, she sought his sterilisation to avoid his fathering, whilst in residential care, a child he could not care for.
Held: The application was refused. Where a . .

Cited by:
See AlsoWyatt v Portsmouth NHS Trust and Another FD 21-Apr-2005
Charlotte Wyatt had been born very premature and so severely disabled that her doctors sought and obtained an order that she should not be revived if she died. She had survived several months longer than expected and her parents had noticed . .
ApprovedRe L (a child) (Medical Treatment: Benefit) FD 1-Nov-2004
(Date) . .
CitedWyatt and Another v Portsmouth Hospital NHS and Another CA 12-Oct-2005
The appellants’ daughter had been born with very severe disabilities. Her doctors obtained an order allowing them a discretion not to ventilate her to keep her alive if necessary. She had improved, but the family now sought leave to appeal an order . .
See AlsoIn re Wyatt FD 23-Feb-2006
. .

Lists of cited by and citing cases may be incomplete.

Human Rights, Health Professions, Children

Updated: 15 November 2021; Ref: scu.216005