A British appeals court ruled that a hospital broke the law when it withdrew from a 68-year-old man without first obtaining court approval amid a dispute with his family.
In a judgment released March 3, Lord Justice Newey, Lady Justice Asplin and Lord Justice Baker said Epsom and St Helier University Hospitals NHS Trust acted unlawfully when it stopped providing dialysis to Robert Barnor Feb. 11 after describing the move as a “clinical decision.”
The court said that when there is a disagreement over withdrawing life-sustaining treatment from a patient who lacks mental capacity, the issue must be decided by the Court of Protection under Britains Mental Capacity Act, the law governing decisions for adults who cannot make them for themselves.
“The hospital cannot pre-empt court proceedings by unilaterally withholding or withdrawing treatment on clinical grounds,” Baker wrote. “A decision whether or not to withdraw treatment has to be a best interests decision. There is no carve out for clinical decisions.”
Barnor died Feb. 27. The had granted permission for his daughter, Lesley Barnor Townsend, to challenge the hospitals decision and sent the case back to the Court of Protection, a specialist court that handles financial and healthcare decisions about vulnerable people who may lack capacity, for an urgent hearing, but no best-interest determination was made before his death.
Barnor had been hospitalized since April after suffering a stroke and a series of further strokes that caused extensive and irreversible brain damage, according to the judgment. He never regained consciousness, though family members said they saw signs of responsiveness, including tracking people with his eyes, blinking on request, reacting to music and squeezing his wifes hand. He later developed severe acute kidney injury and required dialysis twice a week.
According to the judgment, the trust obtained opinions in late 2025 from three outside specialists after doctors concluded that continued dialysis was clinically inappropriate. The court said two of those reports could properly be described as second opinions, but that Professor Lynne Turner-Stokes report was “not a conventional second opinion” because she did not examine Barnor.
The family was told at a Feb. 6 meeting that clinicians had decided Barnor was not suitable for long-term dialysis. In a Feb. 11 letter, the trusts solicitors said no further long-term dialysis would be provided and argued the matter was a clinical decision that did not require prior approval from the Court of Protection.
Townsend then sought permission to bring the case in the Court of Protection. The application was refused Feb. 17, but she filed an appeal Feb. 19. The Court of Appeal heard the case Feb. 23, later granting permission for the application and sending the matter back for an urgent hearing.
The appeals court stressed that courts cannot force doctors to provide treatment they consider clinically inappropriate. But it said that when a patient lacks mental capacity, a dispute over withdrawing life-sustaining treatment must still be handled as a best-interests question under the Mental Capacity Act.
A spokesperson for Epsom and St Helier University Hospitals NHS Trust told , “Our sympathies are with the family at this very difficult time.”
Townsend said in a statement to the Christian Legal Centre that she hoped the judgment would help protect other families facing similar situations.
“It is too late now to save my fathers life, but the system which took it away should be held accountable for that, for the sake of other peo
