Kidney failure patient forced to have dialysis
Doctors have been given the power by a court to force a man dying of kidney failure to have dialysis against his will.
By Stephen Adams, Medical Correspondent
10:00PM BST 29 May 2012
The man, who cannot be identified for legal reasons, had resisted dialysis and doctors believe that without it he will die within weeks.
Managers at the hospital where he is being treated applied to the Court of Protection for legal permission to use proportionate restraint, if necessary, to force him to have the life saving treatment.
Lawyers acting for the English hospital trust, which cannot be named to protect his identity, argued that he lacked the capacity to make decisions about his medical care.
The man, referred to in court as Mr S, did not want to die, emphasised Vikram Sachdeva, acting for the trust.
About 10 days ago he told a doctor that he did not believe his condition was bad enough to warrant dialysis.
Mr Sachdeva told the court: “He said, ‘I don’t believe I’ve got a life threatening illness.”
However, over the next week his condition deteriorated significantly.
“The consequences of no treatment were potentially extremely serious,” said the barrister.
On Friday Mrs Justice Parker granted the trust an order enabling clinical staff to restrain Mr S during dialysis, if necessary. In the event, he complied with treatment and received dialysis over the weekend, noted Mr Sachdeva.
Yesterday (Tuesday), the judge agreed to extend the order indefinitely, after accepting that Mr S did lack the capacity to make decisions about his care. She noted Mr S’s relatives supported the trust’s application.
However, she said clinicians needed to be very careful about the degree of restraint needed.
She said: “Nobody is suggesting that the gentleman is restrained in a straight-jacket or anything like that, it has to be proportionate. Restraint may exacerbate the medical difficulties.”
She continued: “What is intended is that he should be gently restrained by having a hand held by each nurse so it is possible to put in a catheter.”
If he became so agitated that he removed lines from the dialysis machine during treatment, which lasted three hours, that could trigger a potentially fatal embolism, she said. The stress of such an episode could also kill him due to a serious heart condition.
She said: “A balance needs to be struck … between saving his life and subjecting him week-in and week-out to invasive treatment that has a capacity to be cruel to him.”