The teenager’s wish to continue treatment ‘is being seen as a reason to deny her dignity as a mentally capable adult. This is a lethal form of paternalism,’ says bioethicist Professor David Albert Jones, director of The Anscombe Bioethics Centre.
By Frank Wright
OXFORD, England— The case of ST versus the NHS Trust seeking to end her life has sparked criticism of the ethics underpinning the judge’s ruling in favor of the latter.
In remarks published on September 5, a leading British bioethicist describes Justice Roberts’ ruling as an example of “lethal paternalism”.
According to Professor David Albert Jones, director of the UK-based Anscombe Bioethics Centre, “The judge has taken a perilous step in interpreting ST’s disagreement with her doctors as tantamount to an inability to use the information she has been given about her condition.”
“She can use it. She just disagrees with it,” Jones argued.
Jones believes that the case hinges, not on ST’s mental capacity, but on the right to disagree with the power of the law and medical professionals to silence her voice and end her life.
“In this case, a vulnerable patient’s disagreement with her doctors is being used against her as a means not only to take away her voice but further to deny her the right to litigate against the decision to take away her voice,” he stated.
“Most disturbingly of all, her wish to continue to receive life-sustaining treatment, such as dialysis, is not only being ignored, but that very wish is being seen as a reason to deny her dignity as a mentally capable adult. This is a lethal form of paternalism.”
ST is a 19-year-old girl suffering from a rare mitochondrial disorder. She is now in intensive care, her life supported by ventilation, dialysis, and a feeding tube. She wishes to continue treatment and hopes to access experimental trials that will extend her life. The NHS, on the other hand, argues that she is both dying and delusional in her “unshakeable belief” that she might live.
Despite the evidence of two psychiatrists, a medical doctor, and the Official Solicitor acting for ST, Justice Roberts found ST, described by “Dr. D” as “comfortable, smiling, alert and in clear consciousness,” mentally incapable of determining her own fate.
In Justice Roberts’ opinion, the 19-year-old ST’s preference for life over resignation to death is proof of her mental incapacity.
She wrote: “The cumulative effect of [ST’s] circumstances over such a prolonged period, her profound inability to contemplate the reality of her prognosis, and a fundamentally illogical or irrational refusal to contemplate an alternative are all likely to have contributed to impaired functioning… It is not necessary for me to seek to further define the nature of that impairment. I am satisfied that it exists and that it operates so as to render her unable to make a decision for herself in relation to her future medical treatment.”
The judgement states also that the hospital trust keeping ST alive is seeking to move her to “palliative care,” a measure which will both remove life-sustaining dialysis from ST and free the hospital from the obligation to attempt to resuscitate her. This plan, published on July 20, 2023, would lead to the teenager’s death, and the Trust is seeking legal authority to begin it. Unless there is a successful legal appeal, she will be stripped of life supporting treatment.
The ruling satisfies the law. Whilst the 2005 Mental Capacity Act makes no explicit mention of “belief,” Justice Roberts decided that ST’s“ unshakeable belief” that she could survive “renders her unable to make a decision for herself.”
The judge notes that ST’s belief in life is rooted in that of three family members, devout Christians, whose religious faith is not mentioned in the recorded judgement.
ST’s parents are seeking the lifting of reporting restrictions in the High Court, which includes a ban on publishing their names, to mount a fundraising appeal to provide for the chance of life-saving experimental treatment in North American clinical trials.
The family told the Christian Legal Centre that they had endured a “year of hell” before being confronted by this judgement.
“We are very distressed by this injustice, and we hope that, by Jesus’s grace, this will be corrected on appeal,” they said.
Tom Allen of Christian Concern told LifeSiteNews that the response from the media has been one of unanimous support.
“The coverage and the approach has been very sympathetic – even from sources like the BBC [British Broadcasting Corporation] which may not usually agree with us,” he said.
If reporting restrictions are lifted, LifeSiteNews will join in the attempt to raise funds to provide ST with the chance of lifesaving nucleoside treatment outside Britain.
Editor’s note. This appears at LifeSiteNews  and is reposted with permission.