Emergency Out of Hours Advice

Drug Overdose and Emergency Treatment

We represented an acute Trust caring for a 14 year old girl who reported taking an overdose of paracetamol. She was assessed as Gillick competent and was refusing diagnostic testing or treatment. Her mother wanted her to receive treatment. The window of opportunity for successful treatment in such cases is narrow; it must be commenced within 24 hours of ingestion. We successfully facilitated an emergency out of hours hearing before a High Court Judge who authorised the forced intervention and treatment of the patient against her wishes.

Injunctions and End of Life

We advised an acute Trust caring for a lady who was receiving end of life care where there was a dispute as to whether or not her son, who was subject to a civil restraining order, could visit her – her life expectancy was a matter of hours. The patient was unconscious, but her previously expressed wishes had been to have contact with her son, contrary to the terms of the injunction.

Unborn Child

We acted for an acute Trust which had been challenged over a decision to withhold treatment from an unborn baby where it was believed to be futile. This case looked at the highly emotive tension that arises between a parental wish for all treatment to be given to a child, set against a clinician's knowledge that such treatment will only cause pain and suffering with no prospect of any recovery. Although the case was issued in the High Court, the principles that had been developed in the Court of Protection were applied. We supported the clinicians and helped the Trust's in-house legal team prepare sensitive but clear evidence; we liaised carefully with the parents' solicitors, all of which helped the court reach a decision which fully took account the parental concerns but reflected the medical reality of the unborn child's condition.

End of Life

We acted for a Trust in a complex disputed end of life care case where an elderly patient's daughter refused to accept that her father should have treatment withheld. The clinicians in this case required considerable support and advice to ensure they felt protected in an environment that had the potential to become hostile. We advised on the legality of proposed care plans and management of the patient's relatives' expectations and behaviour, provided guidance in decision-making processes, supported clinicians in the preparation of witness evidence, drafted the application and prepared appropriate documents such as the care plan. We supported witnesses at the hearing and provided dynamic advice in parallel to the patient's condition and other parties' approaches. Ultimately, the decision reached was accepted and implemented but more importantly, the stress of a difficult, emotionally charged hearing did not turn into an inquisition and the Trust staff were able to discharge their duty as part of a public authority acting lawfully and appropriately.