(LifeSiteNews) — A U.K. judge has ruled that a young woman who is dying from anorexia can be sent home from the hospital and not be fed through a tube.
The 24-year-old woman, known only as “Patricia,” has been granted legal permission to refuse lifesaving artificial nutrition. A long-term anorexic, she has been described as being “days or even hours” from death.
The decision, reported on October 5, arose from a judgment in the Court of Protection. The court was approached by the NHS trust treating Patricia to ensure that they should respect her alleged wish to end her life.
Patricia’s parents condemned the court’s ruling, telling the Daily Telegraph that they are “absolutely appalled” by it.
“[The judge, Mr. Justice Moor, has] sentenced someone who desperately wants to live to what we fear will be a hideous death,” they said.
Despite Patricia having signed an “advanced directive” last year, which allows her to refuse a feeding tube, her family maintain not only that she is too sick to be capable of making a rational judgment but that she has asked for help on many occasions since that time.
“No one told the judge that she is changing her mind every five minutes,” said one family member.
“You can’t just [decide from] the last thing she said. What about the fact that, in her own words, she has been ‘screaming for help’ for weeks?” Patricia’s relative continued.
“While the judge was telling the court he was ‘absolutely clear’ Patricia would agree with him that she should be able to refuse tube-feeding by restraint, Patricia herself was telling her family the exact opposite – that she wanted to be sedated and tube fed; she just couldn’t cope with being fully aware while it was happening.”
In the United Kingdom, basic necessities of life for very sick people, like artificial hydration, feeding tubes, and respirators are described as “care” or “treatment” which a patient may refuse. Doctors may go to court to refuse to continue to “treat” a patient with such life sustaining means.
The Telegraph report cites the advice of a legal expert in mental capacity.
According to barrister Alexander Ruck-Keene KC, “A case where a judge makes this decision despite the individual not only expressing conflicting wishes, but apparently taking action to seek help for their condition, would on the face of it be unusual.”
The case has deeply concerned at least one U.K. politician.
Conservative MP Caroline Nokes said, “These cases are both heartbreaking and deeply worrying.”
“Anorexia is a severe mental illness and often patients’ resolve to seek treatment does waiver,” she continued.
“We need to do better than we currently are at securing treatment for sufferers when they ask for it. It is the lost opportunities to secure treatment that is exacerbating cases as tragic as this one.”
The verdict in Patricia’s case seems to be in keeping with the Advanced Directive to Refuse Treatment which she signed last year.
However, psychiatrist Dr. Agnes Ayton, who co-wrote the national guidelines on the treatment of patients with severe eating disorders, told the Telegraph that a malnourished anorexia patient “does not have capacity” to sign an advance directive to refuse treatment (ADRT).
“A patient who has a longstanding eating disorder does not have capacity to sign an ADRT when they are ill and malnourished,” she said.
Anorexia as a legacy of lockdown
Conservative MP Danny Kruger said that “offering wholly inappropriate legal documents to refuse treatment and ‘palliative care’ rather than urgent medical intervention” is a “national scandal” that compounds the mental health impact of lockdown on young people.
The Court of Protection allows for similar decisions to be taken in the case of people as young as 18. A June 20, 2023, Daily Mail report warned that the number of teenage girls with eating disorders had “soared by 42%” since the government’s COVID measures began.
Cases of death by anorexia in the UK doubled under lockdown. Prior to the pandemic, around 23 people died from eating disorders every year.
By 2020, this rose to 34, and according to the latest data from 2021, 47 people died from an eating disorder that year.
Since 2021, the Court of Protection has granted five other women the right to die by refusing lifesaving feeding tubes; all were judged to have lacked the mental capacity to make such a decision.
A U.K.-based eating disorder campaigner spoke of the widespread implications of the case. Hope Virgo, herself a recovered anorexic, said, “I’ve been contacted by people who say they are discharged because they’re too sick or not recovering fast enough, and being told there’s nothing more that can be done.”
“It’s heartbreaking,” she added. “Some have been referred to palliative care. We don’t give up on patients with physical illnesses; we find different treatment methods which work for them.”
“’And yet, with eating disorders, it’s still a case of one-size-fits-all. Why aren’t we setting people up to have a chance of recovery? Instead, if treatment doesn’t work, services are washing their hands of them.”
The girl refused her chance to live
The case recalls the recent ruling over a British teenage girl with a rare mitochondrial condition.
Sudiksha Thirumalesh, then known to the press as “ST,” was denied by the Court of Protection the lifesaving treatment she wanted earlier this year. The Court sided with the NHS in ruling that she lacked the capacity to make decisions about her own care.
This judgment was reached despite the evidence of several medical professionals that she was mentally fit.
Speaking of her case, Thirumalesh said, “I have found myself trapped in a medical and legal system governed by a toxic paternalism which has condemned me for wanting to live.”
She died of cardiac arrest on September 12 after being refused CPR. She was 19 years old.