A patient branded “delusional” by doctors after she rejected their plan to end her life on a death pathway has been exonerated by a court almost a year after she died.
Sudiksha Thirumalesh, a 19-year-old student, instructed her lawyers to get her out of the UK when doctors gave up hope that she would recover sufficiently to be moved from the ventilator that kept her alive.
She died last September shortly after the Court of Protection sided with doctors at University Hospitals Birmingham NHS Foundation Trust who wanted to put her on palliative care even though she told a treating psychiatrist: “I want to die trying to live … we have to try everything.”
The Court of Protection concluded that she did not have mental capacity to make her own decisions simply because she rejected the opinions of the doctors, saying her “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”.
Her parents, Thirumalesh Chellamal Hemachandran and Revathi Malesh Thirumalesh, mounted a posthumous challenge to the decision <a href="https://www.judiciary.uk/judgments/thirumalesh-chellamal-hemachandran-and-another-v-sudiksha-thirumalesh-and-another/"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">and the Court of Appeal this week ruled that he lower court acted incorrectly.</mark></a>
Lady Justice King, Lord Justice Singh and Lord Justice Baker accused doctors of 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”.
The appeal court judges said the patient was entitled in law to be assumed to have capacity to make her own decisions “and this remarkable young woman therefore had her wish to ‘die trying to live’.”
The hospital, however, argued that death was in her “best interests” and the Court of Protection ruling meant that she was unable to protect herself from a palliative care process which characteristically involves the removal of life-saving treatment combined with heavy sedation and the removal of food and fluids.
The student had been entirely dependent on a ventilator to breathe, a tube to receive nutrition, and a haemodialysis machine since suffering a respiratory attack in 2022 after she contracted Covid-19.
Because she had encephalomyopathic mitochondrial DNA depletion syndrome, a progressive mitochondrial illness, doctors said she could not improve and opposed her plan to seek permission to go to the United States or Canada to take part in clinical trials for experimental nucleoside treatment which might give her a chance of survival.
<a href="https://christianconcern.com/ccpressreleases/court-of-appeal-overturns-the-judgment-which-declared-19-year-old-mentally-incompetent-only-because-she-disagreed-with-her-doctors-advice-to-stop-life-saving-treatment/"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">Her parents said after the appeal court hearing in London that they were grateful to the appeal court judges for the chance to “challenge the frightening and unfair judgment made against Sudiksha even after her death, and for setting the law straight”.</mark></a>
“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,” they said.
“This case should have never been taken to the courts. Sudiksha clearly had capacity to make her own decisions, and it was only the toxic paternalism of the Trust which caused them to seek to overrule Sudiksha’s wishes in the courts.”
They added: “We did not want this legal battle, which ruined our lives and deprived Sudiksha of her chance to raise funds and see if nucleoside treatment could save her.
“Alas, the belated recognition of some of the errors made in her case cannot bring her back.”
“Andrea Williams, chief executive of the Christian Legal Centre, which supported the family, said: “Sudiksha caught the world’s attention because of her beauty and courage.
“She told the court that if she were to die, she wanted to die trying to live. That’s exactly what she did.
“Good law and good healthcare promotes and protects life and does not create loopholes to ‘choose’ or impose death.”
<a href="https://www.bioethics.org.uk/news-events/news-from-the-centre/press-release-lethal-paternalism-the-case-of-st/"><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-vivid-cyan-blue-color">The original ruling was severely criticised at the time by Professor David Jones of the Oxford-based Anscombe Centre of Bioethics, </mark></a>a bioethics institute serving the Catholic Church in Great Britain and Ireland, as a “perilous step” toward a “lethal form of paternalism”.
“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,” he said.
