United Kingdom: doctors withdraw treatment and call it natural death
Contrary to the wishes of his family, doctors suspended dialysis for RB, a stroke victim, without going through the courts, condemning him to a certain and rapid death. They justified this as a 'clinical decision'. Today, judges will rule on the legitimacy of this practice.
A new end-of-life case in the United Kingdom reveals how another critical medical threshold has been crossed, such that doctors feel entitled to cause the death of a patient, regardless of the family's wishes and without a court order, justifying the withdrawal of life support as a “clinical decision” within their competence.
This unprecedented case concerns a 68-year-old Christian man, who can only be referred to by his initials, RB, by court order. As readers of the Daily Compass know, the procedure for controversial end-of-life cases in Britain has been as follows: doctors want to withdraw life support; the family contests their decision; the NHS Trust takes the family to court; and the judges invariably agree with the doctors.
In RB's case, however, doctors withdrew his life support against the family’s wishes and without going to court. This left the family with the daunting task of initiating legal proceedings. The legal dispute therefore centres on whether doctors can introduce a new procedure whereby a ‘clinical decision’ is sufficient to discontinue treatment and override the family's wishes, thus eliminating the need for court intervention.
In April 2025, RB, who has diabetes and requires twice-weekly dialysis treatment, was admitted to an NHS intensive care unit in London after suffering a severe stroke and collapsing at home. Despite sustaining significant brain damage, his neurological condition improved in the following months and he was successfully weaned off the ventilator by summer. He was able to open his eyes and move his head.
However, doctors informed RB's family that, given the severity of his brain injury, it was in his 'best interests' to discontinue life-sustaining treatment. According to family members, at one point, one of the healthcare professionals reportedly told the family, 'I'm sorry we kept him alive at the start'.
From summer 2025 onwards, the family repeatedly requested access to medical records and imaging to obtain an independent neurological opinion to confirm or challenge the clinicians’ assessment. These requests were resisted for months. The family's attempts to arrange for the patient to be discharged home, transferred to a care facility, moved to a neuro-rehabilitation unit or relocated from intensive care to a specialist renal ward were all refused.
Both parties therefore agreed to resort to mediation to explore the possibility of reaching an agreement on the patient's treatment. However, while the date of the mediation was still being finalised, the family was suddenly summoned to a meeting. During the meeting on 18 February, the doctors informed the family that they had made the 'clinical decision' to stop RB's dialysis and provide palliative care until his 'natural' death. The doctors treating RB justified their decision, stating that they believed the patient would no longer be able to regain an worthwhile quality of life. From that moment on, RB was denied dialysis, which has had obvious lethal consequences for his fragile health.
Faced with the prospect of certain and rapid death, RB's family decided to take urgent legal action, hoping to obtain an order compelling the doctors to resume treatment. The Court of Appeal hearing took place on Monday, 23 February. However, instead of reminding the doctors of their legal obligations, the judges referred the case to the Court of Protection, which deals with such controversial cases and should therefore have been involved from the outset. More significantly, knowing that time was running out for RB, the judges did not order the hospital to resume treatment pending the final decision. By doing so, they effectively favoured the doctors. The Court of Protection hearing is scheduled for today, Friday 27 February, but RB by now could die at any moment.
Backed by Christian Concern, the family's lawyers are arguing that the hospital's decision is 'unlawful' because mediation had already been scheduled to take place shortly to determine RB's 'best interests'. In similar cases, the lawyers say that the hospital is required to refer the matter to the Court of Protection to determine who is right, but this has not been done. Therefore, life support cannot be withdrawn until the court has ruled on the matter.
The medical staff obviously have a different opinion: They claim that RB's situation does not fall under the Court of Protection's jurisdiction, so their decision to withdraw dialysis is justified. This decision was backed by second opinions from three external doctors.
Andrea Williams, chief executive of the Christian Legal Centre, which is supporting the family, said, "Clinicians do not have the power to end a patient's life by withdrawing treatment simply because they prefer their own view over the family’s. Judicial oversight of such life-or-death decisions is the one remaining legal safeguard — however weak and inadequate as it currently is — for the principle of sanctity of life and to protect the rights of families against irreversible decisions driven by the culture of ‘right to die’.”
The case of RB once again highlights the ongoing tension between medical judgement and the wishes of families. Above all, however, it shows that, even though established practice would have that the decision on life support is taken by the Court of Protection (which usually agrees with the doctors), and even though there is no law in the UK authorising euthanasia, doctors are already one step ahead in hastening the death of their patients. If the Court of Protection approves the legitimacy of the 'clinical decision' today, the UK will take another step forward in promoting the 'culture of death'.
