End of life and the courts

What this lesson covers

Who decides, and how
The cases to know
Stopping treatment and DNACPR
Mediation and the reform debate
How this comes up on the day

The words to use

Best interests: The test for a child's treatment when parents and doctors disagree: the child's welfare in the widest sense is paramount, ahead of anyone else's wishes.
Presumption in favour of life: Courts start strongly in favour of a course that prolongs life, but the presumption can be outweighed when treatment's burdens exceed its benefits.
DNACPR: A decision that CPR will not be attempted if the heart or breathing stops. It covers CPR only; other care and treatment continue.
Time-limited trial: Starting intensive treatment for an agreed period, then reviewing it. It only works if stopping is as acceptable as never starting.
Mediation: An independent third party helping families and clinicians talk. The 2023 Nuffield review found it can help but saw no evidence for making it compulsory.

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The words to use

Best interests

The test for a child's treatment when parents and doctors disagree: the child's welfare in the widest sense is paramount, ahead of anyone else's wishes.

Presumption in favour of life

Courts start strongly in favour of a course that prolongs life, but the presumption can be outweighed when treatment's burdens exceed its benefits.

DNACPR

A decision that CPR will not be attempted if the heart or breathing stops. It covers CPR only; other care and treatment continue.

Time-limited trial

Starting intensive treatment for an agreed period, then reviewing it. It only works if stopping is as acceptable as never starting.

Mediation

An independent third party helping families and clinicians talk. The 2023 Nuffield review found it can help but saw no evidence for making it compulsory.