Jenny Kitzinger jennykitzinger

Withdrawing clinically inappropriate life-sustaining treatment – the latest Strasbourg word In light of the cases that are coming before the Court of Protection about the dividing line between treatments which are clinically inappropriate (and hence are not on the table), and treatments which are not in the person’s best interests (and hence are in principle on the table), Medmoune v France ECHR 27, is of no little importance as the latest Strasbourg word on the position.

Withdrawing clinically inappropriate life-sustaining treatment – the latest Strasbourg word

In light of the cases that are coming before the Court of Protection about the dividing line between treatments which are clinically inappropriate (and hence are not on the table), and treatments which are…

23.02.2026 08:22 — 👍 1 🔁 2 💬 0 📌 0

Is there space for clinical decision-making in relation to incapacitated adults? The CA pronounces The Court of Appeal in Townsend v Epsom & Helier University Hospitals NHS Trust EWCA Civ 195 has handed down a decision with very significant implications for all medical decision-making in relation to adults lacking capacity. In the context of an urgent appeal against a decision of the Vice-President, Theis J, Baker LJ (giving the lead judgment), set out at paragraph 68 a series of principles that he considered to be “clearly and consistently established by the case law and professional guidance.”

Is there space for clinical decision-making in relation to incapacitated adults? The CA pronounces

The Court of Appeal in Townsend v Epsom & Helier University Hospitals NHS Trust EWCA Civ 195 has handed down a decision with very significant implications for all medical decision-making in relation…

03.03.2026 13:08 — 👍 3 🔁 3 💬 0 📌 0

Contested decision-making about life-sustaining treatment for adults after catastrophic brain injury Is current law and practice fit for purpose and how can we work together to make it better? Check out this forthcoming talk at Oxford on NBT / PIT / medical futility. As we get ever better saving lives through improved emergency services, we rescue more people who would otherwise have died at the scene of their injury. Some of those will have catastrophic brain injury remain in prolonged disorders of consciousness. An increasingly frequent challenge for clinicians is what happens when it becomes clear that either: * the patient has an unsurvivable brain injury and simply cannot be saved, * or that they will not regain a quality of life that they would value. How do we manage expectations and difficult decisions, and how do we humanely and legally discontinue unwanted further treatments if they are no longer clinically inappropriate to offer or are not in the patient’s best interests? From a legal perspective there are two distinct pathways for decision-making: Clinical: It is first up to clinicians to decide which treatments are clinically appropriate to offer (usually on the basis that it is likely to be effective and do more good than harm). Best interests: Then, if a treatment is on offer, for patients who lack capacity to decide for themselves, the Mental Capacity Act 2005 requires us to determine whether giving it would be in their best interests and in line with their likely wishes so far as these can be ascertained. Case law in the last decade or so has established that: * It is the giving, not the withdrawing of treatment that has to be justified, and * the key prognostic question is not whether the patient will regain consciousness, but whether they will regain a quality of life that they themselves would value. Importantly, if a treatment is not clinically appropriate to offer this is a clinical decision and not a best interests one. Disputes about these two types of decision are dealt with differently by the English law – through different judicial pathways in different courts. However, clinicians for the most part do not understand the difference and frequently muddle the language. But they are not alone – lawyers (and even some judges) have been known to do so as well! Since 2018, decisions to discontinue clinically-assisted nutrition and hydration no longer require declaratory relief from the court provided all parties are in agreement about the patient’s best interests and the relevant guidance has been followed, but this decision-making is a complex and iterative process which is often poorly understood. Moreover, as best interests discussions have become part of routine practice, they have often highlighted areas of disagreement and the Court has been critical of organisations who delay in bringing the matters to Court. As a result more cases are coming to the court and earlier in the acute phase of care. But the legal processes involved are often time-consuming and expensive. The NHS has not have allocated resources for them and applications started in good faith can be overtaken by more rapidly-moving clinical events, rendering them ultimately redundant and resulting in a waste of scarce clinical time and resources along the way. In this lecture, Prof. Turner-Stokes will explore some of the clinical nuances of this decision-making process, discuss some of the legal conundrums that have arisen from recent experience, and address whether the current system is fit for practice – and if not how we might be able to work together to improve it. About the speaker Professor Lynne Turner-Stokes DM FRCP MBE is a consultant in rehabilitation medicine and Director of the Regional Hyper-acute Rehabilitation Unit (RHRU), Northwick Park. The RHRU provides in-patient and community outreach services for younger adults with severe complex neurological disabilities. She has a special interest in the management of patients with prolonged disorders of consciousness (PDOC) from diagnosis to end of life care. In her academic role as Northwick Park Professor of Rehabilitation Medicine, King’s College London, Prof. Turner-Stokes chairs the Guidelines development group for the Royal College of Physician’s national clinical Guidelines for patients in PDOC, and was the lead editor for the final production of the guideline documentation. She has been extensively involved with the legal aspects of clinical and best interests decision-making working with clinicians and legal teams, as well as acting as an expert witness in court proceedings.

03.03.2026 08:17 — 👍 2 🔁 1 💬 0 📌 0

Talk titles: palliative care & …needs of people with severe mental illness, getting prescription meds right, socio-economic inequalities & role of art & creativity

Great set of talks this morning on Palliative care &….
- needs of people with severe mental illness

- getting prescription meds right

- socio-economic inequalities

- + role of art & creativity.

Thank you @peolcsw.bsky.social

03.03.2026 12:14 — 👍 1 🔁 0 💬 0 📌 0

Why isn’t the Greens’ growing success reflected in media coverage? Greens have not received more airtime in recognition of their growing popularity.

Write up of our latest research on impartiality, and why the Greens are still struggling for a broadcast breakthrough

27.02.2026 19:39 — 👍 2 🔁 3 💬 0 📌 0

#hotofthepress 🔥

Mary Miller from @ouhospitals.bsky.social reports on current practice in prolonged disorders of consciousness ⬇️

www.sciencedirect.co...

23.02.2026 10:00 — 👍 0 🔁 1 💬 0 📌 0

Drs. @ginapiscitello.bsky.social and @hauschildt.bsky.social discuss their research on hospital policies influencing clinician approaches to decisions to withhold or withdraw life-sustaining treatment among patients admitted to an #ICU: www.chestnet.org/guidelines-a...
@gretchemaben.bsky.social

17.12.2025 19:37 — 👍 5 🔁 4 💬 0 📌 0

Contested decision-making about life-sustaining treatment for adults after catastrophic brain injury - Green Templeton College Details Date: March 19 Time: 05:45 pm - 07:30 pm Event Category: Lectures and Seminars

The question of whether life-sustaining treatment is on offer or not …&, if it is, how best interests are determined, will be addresses in this public lecture

“…is current law & practice fit for purpose?”

Further info & opportunity to register for online link here: www.gtc.ox.ac.uk/news-and-eve...

19.02.2026 10:28 — 👍 1 🔁 1 💬 0 📌 0

Judgment highlights realities of navigating health & welfare decisions “of a kind that rarely makes it to court…failure by hospital to consult with an LPA - a professional who moved “heaven & earth to correct the situation.”
Indeed, a rapid & effective challenge - awful that court action needed!

14.02.2026 13:26 — 👍 1 🔁 1 💬 0 📌 0

Brain Death Backlash: Unregenerately Variable and Illegal Standards for Determination of Death by Neurological Criteria I am getting ready for my talk for the MacLean Center for Clinical Medical Ethics 2025-26 lecture series. My talk is "Brain Death Backlash: Unregenerately Variable and Illegal Standards for Determination of Death by Neurological Criteria." But check out the other talks that will all be archived on YouTube. Just this month on the same topic are Lainie Ross on "Defining Death: The Case for Choice," Brendan Parent on "Respecting and Learning from the Dead: Ethical Research Involving the Physiologically Maintained Deceased," and David Magnus on "Brain Death Is Really Death. It’s Just Not REALLY Death."

12.02.2026 17:10 — 👍 0 🔁 1 💬 0 📌 0

Contested decision-making about life-sustaining treatment for adults after catastrophic brain injury - Green Templeton College Details Date: March 19 Time: 05:45 pm - 07:30 pm Event Category: Lectures and Seminars

“Contested Decision-making about Life-sustaining Treatment for adults after catastrophic brain injury”

Public lecture @ox.ac.uk by Prof Lynne Turner-Stokes. 19th March, 5.45pm

Further info + Register to get online link, or to reserve a seat in person:

www.gtc.ox.ac.uk/news-and-eve...

10.02.2026 12:39 — 👍 4 🔁 3 💬 0 📌 0

Consultation with Health and Welfare Attorneys/Deputies: A ‘lacuna in the system’ exposed in Cwm Taf Morgannwg UHB v RW In ignoring her role as decision-maker and failing to consult about treatment, the hospital displayed “a stark disregard for and misunderstanding of the Mental Capacity Act 2005” said the Hea…

New blog alert

Hospital makes serious medical treatment decisions for P without consulting his Health & Welfare Attorney.

Happens all the time - but Attorney in this case (a solicitor) & she got it before the VP.

By @jennykitzinger.bsky.social

openjusticecourtofprotection.org/2026/02/01/c...

02.02.2026 07:11 — 👍 2 🔁 3 💬 1 📌 1

“There is a clear distinction between the public interest and what the public is interested in.”

In case you missed it! 𝘓𝘦𝘨𝘢𝘭 𝘈𝘤𝘵𝘪𝘰𝘯's #CourtOfProtection update covers transparency rulings, capacity, best interests decisions & cross-border jurisdiction.

Read on➡️ hi.switchy.io/l0F2

01.12.2025 13:00 — 👍 1 🔁 1 💬 0 📌 0

P’s Advance Decision to Refuse Treatment is not valid, not applicable, and not a reflection of her past or present wishes It seems to me that the judge was entitled to make the decision that P’s ADRT was invalid. That causes me concern because of what it means not just for P but for everyone else with ADRTs. Do our A…

**

New blog post - 90-year-old woman and her advance decision to refuse treatment

openjusticecourtofprotection.org/2025/11/05/p...

06.11.2025 08:04 — 👍 0 🔁 4 💬 0 📌 0

Attorneys disagree about a house purchase for their mother: Case management for a final hearing Court of Protection judges are very experienced in dealing with fraught situations and family dispute. The stakes are high when family members disagree about the care or finances of a relative who …

New blog post

Attorneys disagree about a house purchase for their mother
By @jennykitzinger.bsky.social

#NotSecretCourt

openjusticecourtofprotection.org/2025/10/12/a...

13.10.2025 06:24 — 👍 1 🔁 2 💬 0 📌 0

An emergency statutory will for a dying man This is a situation that could confront any of us – and our partners, ex-partners, family and friends. … Another lesson from this case is the need to keep wills under review. One option…

New blog post

His 2014 will gives his ex-partner rights he now says he doesn't want her to have.

But he lacks testamentary capacity.

His son and daughter apply to the court to change his will

openjusticecourtofprotection.org/2025/09/11/a...

12.09.2025 08:59 — 👍 0 🔁 2 💬 0 📌 0

Cheshire West Revisited By Lucy Series, 9th October 2025 Note: On 20th October 2025, the Supreme Court will be asked to re-visit the question of how to understand a deprivation of liberty. You can read about the backgroun…

The second in our series of blogs about the upcoming Supreme Court hearing concerning DOLS and Northern Ireland.

"Cheshire West revisited"
By @thesmallplaces.bsky.social

openjusticecourtofprotection.org/2025/10/09/c...

10.10.2025 16:45 — 👍 2 🔁 3 💬 0 📌 0

Complaints vs breaches: An analysis of how often BBC and Ofcom find broadcasters have broken rules on impartiality — Researching the impartiality of political news On 25 September 2025, the BBC’s Executive Complaints Unit (ECU) published its ruling on the livestream of a Glastonbury performance by punk-rap duo Bob Vylan that featured alleged hate speech.. T...

Following on from our Conversation article, Dr @mattwalshjourno.bsky.social, Dr @maxwellmodell.bsky.social, Prof. @stephencushion.bsky.social & I have just published a deeper dive into the Ofcom and BBC complaints data for 2025 on our website.

🔗 www.enhancingimpartiality.com/blog/ofcom-b...

TLDR 👇

09.10.2025 08:44 — 👍 6 🔁 5 💬 1 📌 0

Opening Conversations On Assisted Dying, Death and Grief A joint Open University in Scotland and University of the West of Scotland event, where assisted dying, death and grief will be explored.

Still time to register for an in-person evening of conversation about death and dying in Dumfries on Nov 25th - looking forward to meeting some of you there! www.eventbrite.co.uk/e/opening-co...

13.10.2025 13:02 — 👍 3 🔁 4 💬 1 📌 0

BBC under fresh pressure over extent of Reform UK coverage Nigel Farage’s party featured in considerably more News at Ten bulletins than Lib Dems over six months, study finds

Our new impartiality study out and in The Guardian - We found Reform given more airtime on TV news likely due to broadcasters taking into account the party’s latest electoral performance and sustained lead in the polls over several months. Thread 1/6: www.theguardian.com/media/2025/s...

12.09.2025 08:42 — 👍 18 🔁 14 💬 2 📌 6

Commentary on Re YD (Refusal of Withdrawal of Treatment) [2025] EWCOP 31 (T3) By Jenny Kitzinger, 20th August 2025 A couple of weeks ago I observed a hearing about ‘YD’, a 60-year-old man in a Prolonged Disorder of Consciousness at the lower end of the spectrum (a vegetative…

Media reporting of this court judgment - the ‘comatose man’s two secret lovers’ & messages via a spiritual medium….

My analysis of the law & public reaction to this important case (refusal to withdraw feeding tube)

openjusticecourtofprotection.org/2025/08/20/c...

21.08.2025 08:48 — 👍 1 🔁 2 💬 0 📌 0

“There are more things in heaven and earth that are dreamt of in the philosophy of NHS treatment” – a Court of Protection story The flipside of the intense focus on the wishes, feelings, beliefs and values of the person required by s.4 MCA 2005, as clarified by the Supreme Court in Aintree v James, is that there may be situations in which, objectively, a person’s medical situation might appear hopeless, but nonetheless continued treatment is in their best interests. Such a case is that of…

“There are more things in heaven and earth that are dreamt of in the philosophy of NHS treatment” – a Court of Protection story

The flipside of the intense focus on the wishes, feelings, beliefs and values of the person required by s.4 MCA 2005, as clarified by the Supreme Court in Aintree v…

14.08.2025 10:41 — 👍 2 🔁 2 💬 0 📌 0

Patient must be kept alive Hospital refused permission to withdraw nutrition and hydration

The Court of Protection has refused to let a hospital trust in north-west London withdraw life support from a 60-year-old man described as being in a permanent vegetative state after his two partners spoke about his belief in the power of spiritual healing.

rozenberg.substack.com/p/patient-mu...

13.08.2025 05:04 — 👍 6 🔁 5 💬 6 📌 0

A patient with “unusual” spiritual beliefs: Is withdrawing a feeding tube in his best interests? By Jenny Kitzinger, 8th August 2025 12th August 2025: The judgment has just been published (click on the case name): The Hillingdon Hospitals NHS Foundation Trust v YD & Others (Refusal of With…

Yes - we observed this court hearing. See my write up here - & reflections on the case in the final section of the blog

openjusticecourtofprotection.org/2025/08/08/a...

13.08.2025 07:18 — 👍 1 🔁 0 💬 1 📌 0

Now with link to judgment, just published today. What did the judge decide? Click on the link at the top of the blog post.

#NotSecretCourt

12.08.2025 18:27 — 👍 4 🔁 4 💬 0 📌 0

The problem with Motability Hire Agreements: A Deputy’s concerns in the COP By Amanda Hill, 11th August 2025 Working like clockwork. This implies each small part moves in precise harmony to keep the larger system functioning. Wouldn’t it be wonderful if the state was like …

The problem with motability hire agreements - by @amandaaphill.bsky.social

openjusticecourtofprotection.org/2025/08/11/t...

12.08.2025 11:32 — 👍 4 🔁 4 💬 0 📌 1

A patient with “unusual” spiritual beliefs: Is withdrawing a feeding tube in his best interests? By Jenny Kitzinger, 8th August 2025 As someone with both an academic research interest in coma and prolonged disorders of consciousness [PDoC] and with family experience in this area, I’ve watched …

A patient with “unusual” spiritual beliefs: Is withdrawing a feeding tube in his best interests?

And why is he still in a specialist rehabilitation bed now that it's been determined he's in a "permanent vegetative state" + not in a care home?

openjusticecourtofprotection.org/2025/08/08/a...

11.08.2025 07:35 — 👍 3 🔁 3 💬 2 📌 0

A patient with “unusual” spiritual beliefs: Is withdrawing a feeding tube in his best interests? By Jenny Kitzinger, 8th August 2025 As someone with both an academic research interest in coma and prolonged disorders of consciousness [PDoC] and with family experience in this area, I’ve watched …

New blog post by @jennykitzinger.bsky.social raises some troubling questions about the operational difficulties in ensuring patients have the right assessment and funding to meet their needs.

openjusticecourtofprotection.org/2025/08/08/a...

11.08.2025 07:39 — 👍 4 🔁 2 💬 0 📌 2

Balancing patient welfare and procedural fairness: Withdrawal of ventilation before Hayden J By Celia Kitzinger, 4th August 2025 The case, COP 20018026, before Mr Justice Hayden on 22nd and 23rd July 2025, appeared in the Royal Courts of Justice Daily Cause list as concerning “seriou…

Balancing patient welfare and procedural fairness: Withdrawal of ventilation before Hayden J by @kitzingercelia.bsky.social

#NotSecretCourt

openjusticecourtofprotection.org/2025/08/04/b...

05.08.2025 07:50 — 👍 3 🔁 2 💬 0 📌 1

This was a disturbing hearing to watch - and my blog raises more questions than answers. Was a court hearing really necessary (or appropriate) for this case? If it was, should the judge have adjourned as the OS requested to permit family to find legal representation?

05.08.2025 09:51 — 👍 2 🔁 4 💬 0 📌 0

Posts by Jenny Kitzinger (@jennykitzinger.bsky.social)