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Supreme Court CANH Ruling — SCE Palliative Medicine MCQ

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HardLegal & Ethical FrameworkSupreme Court CANH RulingSCE Palliative Medicine

A palliative care nurse asks about the legal framework for withdrawing clinically assisted nutrition and hydration (CANH) from a patient in a minimally conscious state. Following the 2018 Supreme Court ruling in An NHS Trust and others v Y [2018] UKSC 46, what changed?

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Correct answer: E — Court approval is no longer mandatory in every case — if the clinical team and family agree that CANH withdrawal is in the patient's best interests, it can proceed without court application, provided established guidelines are followed

The Supreme Court in An NHS Trust and others v Y [2018] UKSC 46 determined that court approval is not required in every case to withdraw clinically assisted nutrition and hydration (CANH) from patients with prolonged disorders of consciousness; instead, if a multidisciplinary team and the patient’s family agree that withdrawal is in the patient's best interests and follow established guidelines, it may proceed without a court application. Previously, court approval was mandatory. Option C is incorrect because withdrawal is lawful not prohibited; B misstates the changed legal requirement; C overrestricts to advance consent; E ignores the significant legal change.

Reference: An NHS Trust and others v Y and another [2018] UKSC 46, as summarised in the Med Law Review article (2019) and NHS guidance (Withdrawing treatment, 2023). https://pubmed.ncbi.nlm.nih.gov/30649508/