Parents in court fight over late daughter's medical treatment

Sudiksha Thirumalesh was involved in a court fight with University Hospitals Birmingham NHS Foundation Trust before her death in September last year.

Author: Claire EmmsPublished 1st May 2024

The parents of a 19-year-old woman who died amid a legal battle with an NHS trust over her treatment have brought a Court of Appeal bid about her ability to have made her own medical decisions.

Sudiksha Thirumalesh, who had a rare mitochondrial disorder, was involved in a court fight with University Hospitals Birmingham NHS Foundation Trust before her death in September last year.

Her parents Thirumalesh Chellamal Hemachandran and Revathi Malesh Thirumalesh are now bringing a challenge to the Court of Appeal after a judge ruled the teenager was not able to make her own decisions concerning her medical treatment.

In the decision in August last year, Mrs Justice Roberts found the teenager had a "complete inability to accept the medical reality of her position".

But Bruno Quintavalle, representing Ms Thirumalesh's parents, told the court in London that experts had found the student had no "impairment of the mind".

He said on Wednesday: "The report shows a young woman very well aware of what she's facing, very well aware of what the medical treatments entail, and very clear that she rejects the care pathway that the hospital wanted her to accept."

In written submissions, Mr Quintavalle continued: "At root, all that there was... was a disagreement between Sudiksha and her treating clinicians; Sudiksha could make a decision, it was just not the decision that the trust wished her to make."

The barrister continued that Mrs Justice Roberts's decision "significantly expands" the reach of the law about mental capacity, adding the ruling "risks removing capacity from a large class of patients who do not accept their doctors' diagnoses or prognoses".

University Hospitals Birmingham NHS Foundation Trust is opposing the appeal.

In written submissions, the trust's barrister Vikram Sachdeva KC said the requirement for a patient to believe "all relevant information" about their treatment does not mean they cannot disagree with a doctor's advice or take different viewpoints into account.

He said: "Where there is medical consensus as to the consequences of having or not having treatment, this is information which a person must understand, in the sense of believing or accepting as true.

"If there is a range of credible views as the consequences of having or not having a particular treatment, then a person needs to understand that there are different views as to the consequences of having or not having treatment and to use and weigh up this information."

The Court of Protection, the specialist family court where Ms Thirumalesh's case was heard, was previously told the teenager wanted to travel to North America for a potential clinical trial.

Mr Sachdeva said Mrs Justice Roberts had considered the medical evidence about Ms Thirumalesh's prognosis and the consequences of the potential treatment, with the judge describing the odds of her being able to undergo this treatment as "exceptionally slim".

The barrister continued: "A failure to accept this relevant information as true meant that Sudiksha did not understand all relevant information and therefore was unable to make a decision for herself in relation to her treatment."

The hearing before Lady Justice King, Lord Justice Singh and Lord Justice Baker is due to conclude on Thursday, with a decision expected in writing at a later date.

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