At a Court of Protection hearing today, before Mr Justice Keehan, I listened to doctors report on how they’d given ‘futile’ & ‘’burdensome’ treatment to a dying man over many weeks. It was like listening to a story of medical torture. #EOLC #NotSecretCourt

The patient, “KM”, in his 50s, was admitted to hospital on 19 Jan with breathlessness & chest pain after long haul flight. It was a pulmonary embolism. Clots reached his heart. He then had a cardiac arrest. Then tested positive for Covid. He has severe & irreversible lung damage.

He's been kept alive for the last 15 weeks with ExtraCorporeal Membrane Oxygenation (ECMO). A machine transports blood from the body to an artificial lung (oxygenator) that, like the human lungs, adds oxygen and removes carbon dioxide.

The Hospital Trust (represented by Emma Sutton, @sutton_es) made an application to court to withdraw ECMO – with the result that KM would inevitably die, probably within minutes. The Trust considers that ECMO is “futile”, “burdensome” & KM will never recover.

KM’s family – his wife, adult son & brother-in-law - oppose the application. They strongly believe that KM would want to be kept on the ECMO machine & they want life-sustaining treatment continued. The family was represented in court by Sam Karim @Kings_Chambers

The Official Solicitor (with Michael Horne @horne_mike as counsel) represented KM. She commissioned a report from independent expert, Dr Chris Danbury. At the start of the hearing the OS did not take a position as to whether continuing treatment was in KM’s best interests.

Evidence was given in court during the day by:
- the treating doctor ("Dr A") & the independent expert @Medic_Mediator
- and family members, & KM’s pastor from the Pentecostal Church he attended

Dr A conveyed a powerful sense that he felt he was doing the wrong thing by his patient by keeping him on the ECMO machine

Dr A: Demands of being critically ill for long time require a lot of energy, we do all we can to mitigate this, but it's difficult to get more calories going in than are being used up. His muscle bulk has almost gone. Bones almost sticking through as so little muscle around them

KM is sedated into semi unconsciousness. He won’t live much longer regardless of any intervention. He has severe pressure sores (one is already through to his skull), & may have pain he can’t express & be experiencing a ‘sensation akin to drowning’ #EOLC

Family's barrister pointed to some notes recording that KM seemed 'comfortable'.
Dr A said staff are reporting great moral distress "because they know they can’t get him better & think they're causing him distress". It's them who care for him. I trust my expert nursing team.