Christian Concern
CV NEWS FEED // Reversing a lower court’s decision, Britain’s Court of Appeal on July 31 ruled that a 19-year-old student who passed away in September was mentally capable of making her own medical decisions.
Catholic News Agency (CNA) reported that the case centered around the medical treatment of Sudiksha Thirumalesh, a Catholic daughter of Indian immigrants. Thirumalesh suffered from a rare mitochondrial disorder that caused muscle weakness and damaged her kidneys and hearing.
According to the BBC, Thirumalesh had wanted to pursue experimental treatment in Canada in the hopes that it would help her disorder. Doctors at her hospital in Birmingham wanted to place her on palliative care, which she objected to.
CNA reported that the woman wanted to “die trying to live.” Her parents also supported her decision to keep fighting for her life.
Thirumalesh’s doctors at University Hospitals Birmingham NHS [National Health Service] Foundation Trust applied to Britain’s Court of Protection and called the woman’s wishes a “delusion,” asking the court to rule that she was mentally incompetent and unable to make her own medical decisions.
According to the Catholic Herald, the court ruled in favor of the doctors and said that Thirumalesh’s “complete inability to accept the medical reality of her position, or to contemplate the possibility that her doctors may be giving her accurate information, is likely to be the result of an impairment of, or a disturbance in the functioning of, her mind or brain.”
CNA reported that the ruling ignored the views of two psychiatrists who had each examined Thirumalesh and declared her of sound mind. After the ruling, Thirumalesh’s doctors moved her to palliative care and cut off her kidney dialysis. According to her brother, Varshan Thirumalesh, the hospital also refused to give her antibiotics for a hospital-acquired infection and withheld her blood pressure medication. She died days later of heart failure.
According to CNA, Thirumalesh’s parents, Thirumalesh Chellamal Hemachandran and Revathi Malesh Thirumalesh, called the court’s ruling “irrational and cruel” and said it had a “devastating impact” on their family.
“From the moment the judgment was made, it gave the clinicians the power to do whatever they liked, with no respect for Sudiksha’s own wishes and treating her family with hostility and contempt,” her parents said. “No real effort was made to secure a clinical trial of nucleoside therapy, which might yet have saved Sudiksha’s life. May God forgive all those who have done this to her.”
Varshan told the Daily Compass that the family’s Catholic values were clearly different from the hospital’s.
“From the beginning, it was clear as Christians we give a different value to life compared to the hospital doctors,” he said. “We believe life always has value and dignity even if the person is very ill. The system instead gives up on life very easily in the name of the patient’s best interests. Staff made fun of our beliefs and mocked Sudiksha. They tried to break her psychologically and to destroy her will to live by telling her repeatedly she was going to die.”
The BBC reported that Thirumalesh’s parents were allowed to pursue a posthumous appeal against the Court of Protection, which it described as “a rare move.” According to CNA, the Court of Appeal ruled on July 31 in favor of her parents, stating that NHS doctors were trying “to shoehorn into the term ‘delusional’ what in reality they regarded as a profoundly unwise decision on Sudiksha’s part to refuse to move to palliative care.”
Justice Eleanor King also wrote that “It is essential always for any person conducting a capacity assessment” to remember that a “person is not to be treated as unable to make a decision merely because he makes an unwise decision,” as stipulated in the Mental Capacity Act.
The Court of Appeal also ruled that the Court of Protection erred in ignoring the views of the two psychiatrists who examined Thirumalesh before her death.
According to CNA, “The new ruling reaffirms the right of patients to disagree with their doctors without the risk of being declared mentally incompetent and having their best interests assessed and enforced by the courts.”
The University Hospitals Birmingham NHS Foundation Trust said in a statement in response to the ruling that it “clarified a difficult legal issue and will hopefully bring some closure to Sudiksha’s family.”
“Sudiksha’s death was deeply upsetting for our colleagues who cared for her for such a long time, and who had always worked to provide the clearest and most compassionate care, treatment, and advice, throughout her time with us in critical care,” the Trust added, according to the BBC. “Our sincere and heartfelt condolences remain with Sudiksha’s family and loved ones.”
The BBC also reported that Thirumalesh’s parents welcomed the Court of Appeal’s ruling.
“We are grateful to the Court of Appeal for an opportunity to challenge the frightening and unfair judgment made against Sudiksha even after her death, and for setting the law straight,” they said. “A patient’s right to disagree with her doctors, not to relinquish hope, and still to have her decisions respected, will now be part of Sudiksha’s legacy.”
