12 September 2023 , 12:07
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A roofer who suffered a brain injury after becoming involved in a fight in a pub garden will have his treatment stopped after a High Court judge ruled that he was dead.
Andy Casey's family had taken his case to court but failed to persuade the court to rule against specialists who said he is brain-stem function had died and he is therefore dead. Mr Casey's sister, Christine, told the judge she did not believe that he was brain-stem dead.
Mr Justice MacDonald ruled that doctors can lawfully stop treating the 20-year-old, from Mitcham, southwest London. He made the ruling today after considering evidence at a private hearing in the Family Division of the High Court, in the Royal Courts of Justice in London on Friday.
Hospital trust bosses responsible for Mr Casey's care had asked the judge to rule that treatment could lawfully end, but his relatives wanted treatment to continue, saying they had seen movement and signs of life. A lawyer representing St George's University Hospitals NHS Foundation Trust, in Tooting, south London, and has responsibility for Mr Casey's treatment, asked the judge to rule that it would be lawful to cease artificial ventilation and care.
Barrister Abid Mahmood told the judge: "This is a tragic matter whereby the trust seeks a declaration that very sadly Andy's brain-stem function has died and that thereby he has died. The trust seeks an order that it is lawful for the trust to cease artificial ventilation and care that Andy currently receives."
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Mr Mahmood told the judge in a written case outline that Mr Casey had been involved in a fight in a pub garden on July 9 and was "punched to the head" and "fell to the ground". He said specialists had diagnosed death on July 16. The judge heard that Mr Casey had remained on a ventilator since being injured.
In a written ruling, Mr Justice MacDonald said: "Whilst I understand fully the conclusions that the family and friends of Mr Casey have, in their sorrow, drawn from his movements and apparent responses to the ventilator, having regard to the totality of the evidence before the court, I am also satisfied that what the family are seeing are in fact well-recognised base reflexes that can survive brain stem death.
"Cruelly, the flattering voice of hope convinces those that love Mr Casey that these are signs that Mr Casey is not dead. With regret, I am satisfied that the brain stem testing undertaken... demonstrate(s) that he is." Mr Justice MacDonald said he had concluded, with "very great sadness" Mr Casey "died on 16 July 2023 at 11.51pm".
He added: "I understand that this will come as a bitter disappointment to Mr Casey's family and friends. The now blurred boundary between life and death can be delineated by reference to philosophy, to ethics or to the cardinal tenets of the world's great religions. But the task of this court is to consider whether Mr Casey has crossed over that boundary for the purposes of the law."
He said he was satisfied, having regard to brain stem testing undertaken in accordance with a code of practice, that Mr Casey had died. "I recognise that this is a tragedy for his family and friends and, whilst I am certain that it will offer little comfort, they have my profound sympathy." Speaking after the ruling, Mr Casey's sister, Christine said: "I'm so angry."
The family have said they plan to appeal the decision. Mr Casey's sister Christine, 27, told the judge she does not believe he is brain-stem dead.
She said the judge had looked at video footage showing Mr Casey moving. She said: "He reacts to pain. I showed the judge so many videos. How can someone who reacts to pain be dead? We are looking at an appeal."
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