A Heart-Wrenching Dilemma: The Case of NR and the Complexities of Life-Sustaining Treatment12/5/2024 Adam Tear solicitor at Scott Moncrieff & Associates acted for the Parents of NR in a recent further case relating to withdrawal of all life sustaining treatment sought by King’s College Hospital, who are treating NR. This is a follow-on case from an earlier judgment on the withholding of CPR here. The full judgment is here. The parents were represented before the Court by Katie Gollop KC and Myles Jackson.
In this further poignant case that underscores the profound ethical and legal dilemmas surrounding life-sustaining treatment, the High Court recently grappled with the decision of whether to continue invasive ventilation and other life-sustaining treatments for a child known as NR. The case, which weighs heavily on the principles of medical ethics and parental rights, sheds light on the intricacies of decision-making when a child's best interests hang in the balance. The court's decision, detailed in the judgment, navigates the complex terrain of medical interventions, parental wishes, and the child's welfare. At the heart of the matter lies the fundamental question: What course of action is in NR's best interests? NR, a child with severe disabilities, has been the focus of intense medical care since birth. Born anophthalmia and with significant neurological challenges, his life has been sustained through invasive treatments, including mechanical ventilation and parental nutrition. Yet, as time has passed, his condition has deteriorated, and the burdens of treatment have mounted. The court, guided by expert medical testimony and legal precedent, weighed the benefits and burdens of continued life-sustaining treatment for NR. It considered the viewpoints of both the medical professionals and NR's devoted parents, who passionately advocated for their son's continued care. Central to the court's deliberations was the principle that the best interests of the child must prevail, even if it means overriding parental wishes. While recognising the profound love and dedication of NR's parents, the court had to assess whether the continuation of invasive treatments truly served NR's welfare. Expert medical opinions painted a sobering picture of NR's prognosis, indicating that the burdens of treatment outweighed any potential benefits. Despite the deeply held beliefs of NR's parents, the court ultimately concluded that it was in NR's best interests to discontinue life-sustaining treatment. As NR's story unfolds, it serves as a stark reminder of the profound complexities inherent in medical decision-making, particularly in cases involving the most vulnerable among us. In the end, NR's case serves as a poignant reminder of the enduring power of love, compassion, and the quest for what is truly in the best interests of the child. NRs treatment as a disabled child, prior to the decision to seek the orders the Trust have, have left many unanswered questions, particularly in relation to the ethics of such decisions, when Parliament has maintained that euthanasia is not allowable in England and Wales. Further it identified a continuing policy of excluding parents from decisions making, such that any positive voice for a child is not considered prior to a decision to cease medical treatment.
0 Comments
The area of contempt is a highly complex area to both prosecute and defend. It is highly technical as well as having a higher burden of proof. After achieving a finding of contempt, obtaining a sentence that promotes your clients position can be a second hurdle to over come followed by the ever more complex issue of costs. AMT Training solutions, with Adam Tear, are offering bespoke training to solicitors firms, in order to deliver effective prosecution of contempt of court matters before the Civil, family courts, and Court of protection. What You'll Learn: Prosecution Strategies: Master the art of building a strong case against contemptuous behaviour in court. From gathering evidence, to the issue of proceedings, to presenting compelling arguments, equip yourself with the skills to effectively prosecute contempt’s of court, and ensure that your client can rely upon enforceable orders. Sentencing Guidelines: Gain insight into the factors influencing sentencing decisions in contempt cases. Understand the range of penalties available to the court and learn how to advocate for fair and just outcomes. Costs: Having obtained a finding of contempt, and a sentence that ensures that the Order of the Court will be obeyed, you must then obtain costs orders which are enforceable. Expert Guidance: Adam Tear, as an advocate has been at the forefront of many of the leading cases on contempt of court, ranging from the initial grant of legal aid in Bunning, through to the leading case of Inplayer, and most recently the MBR series of cases, providing guidance on Pat 81, and particularly service issues. Whilst often on the defence side, Adam regularly prosecutes contempt of court, and has a wide-range of experience at all levels from the County Court through to the Supreme Court. Adam's training combines theoretical knowledge with practical insights to ensure you receive the highest calibre of training. That assistance will run beyond training, and Adam will be available to assist with ongoing cases. Secure Your Clients Success: Contempt of court matters demand precision, diligence, and a deep understanding of the legal principles. Arm yourself with the tools you need to excel in this critical aspect of legal practice, and achieve the best outcomes for your clients.
Contact us today to learn more about our upcoming training sessions and secure your place amongst the ranks of solicitors proficient in contempt of court proceedings. Adam Tear solicitor at Scott Moncrieff & Associates acted for the Parents of NR in a recent case relating to ceiling on treatment sought by King’s College Hospital, who are treating NR. The full judgment is here The parents were represented before the Court by Katie Gollop KC and Myles Jackson.
NR is a child with severe disabilities and life-limiting health conditions. NR requires mechanical ventilation and faces challenges such as interstitial lung disease, abdominal discomfort, and recurrent sepsis. Despite limitations in verbal communication, evidence suggests NR can experience pleasure and pain, with monitoring through a FLACC score. The Trust sought court declarations to withhold three types of treatment. The first was various medical treatments (such as inotropes) in the event that his condition worsened, the second was restriction of access to ventilatory support in the event that he was extubated and then deteriorated, and the third was CPR in the event of a cardiac arrest. A week before the hearing, the parents proposed adjournment of determination of the application for the withholding of ventilatory support declarations. The Trust agreed to that at the door of the court. There was significant agreement about the first group of treatments and therefore the Court’s focus was on the withholding of CPR in the event of a further cardiac arrest. Despite disagreements among the parties, as to what is the best interests of NR the court emphasised the key legal principles, including the paramount consideration of the child's best interests and a presumption in favour of preserving life. Professional guidance from the Royal College of Paediatrics and Child Health is considered, particularly in relation to CPR. The court accepted valid concerns about signalling future decisions on withdrawing life-sustaining treatment, but rejected them, on the basis that the Judge would exclude this from his decision-making approach. The Court determined the CPR issue now, to provide clarity for clinicians, parents, and NR. The decision aims to balance justice, fairness, and the unique circumstances of NR's case. Medical experts project a bleak prognosis, estimating a limited life expectancy. The parents, guided by their religious beliefs, emphasise NR's meaningful life and wish for continued extended care. The medical experts were unanimous that CPR was unlikely to be successful. Despite the parents' opposition, the court decided that it would is not be in NR's best interests to receive CPR, emphasising the physical burden it poses and the unlikely prospects of successful resuscitation. The ceilings on treatment would however be lifted for any planned procedures, for the period leading up to and six hours post operation. The Court also emphasised that whilst its declarations permitted a ceiling of treatment, they did not prevent stop any clinician from providing such treatment if they considered it to be clinically justified. The judgment acknowledges the parents' devotion and expresses gratitude for their collaborative approach, recognising the difficulty of the decisions they face. The court's decision aims to provide clarity to all parties while emphasizing the ongoing respect for NR's best interests and the legal principles outlined in the judgment. Adam Tear and the legal team will continue to advise and represent the parents between now and the final hearing listed for 3 days in April. Prior to that hearing, the Trust may pursue its application for a ceiling of ventilatory treatment, if NR meets the criteria for extubation, or it may apply for a declaration that it is lawful for ventilation to be withdrawn with the consequence that NR will die. Part 81.4 of the Civil Procedure Rules and Part 37.4 of the Family Procedure Rules, both require that an application contains "confirmation that any order allegedly breached or disobeyed included a penal notice". A Penal Notice is a prominent notice on the front of an order warning that if the person against whom the order is made (and, in the case of a corporate body, a director or officer of that body) disobeys the court's order, the person (or director or officer) may be held in contempt of court and punished by a fine, imprisonment, confiscation of assets or other punishment under the law. Easy you say, what is the issue.
A practice particularly in the family courts fuelled by the standard orders having a penal notice already within them, has caused a situation where by disobedience of an Order with a penal notice is common. Not least by unsuspecting Court staff who may not realising that they are covered by these all encompassing penal notices. Every breach of a Court Order is contemptable, but only those that are covered by a penal notice, are subject to the sanctions of a fine, or imprisonment for such contemptable behaviour. The inclusion of a penal notice in a court order is not automatic or mandatory; its necessity is determined on a case-by-case basis. Courts consider various factors, such as the nature of the order, the likelihood of non-compliance, and the potential harm caused by non-compliance, when deciding whether to include a penal notice. Lawyers play a crucial role in drafting effective penal notices that clearly communicate the consequences of non-compliance. The notice should be concise, unambiguous, and prominently displayed within the court order, ensuring that the party bound by the order is aware of the potential ramifications of their actions or inactions. Penal notices must and should be directed to a specific element of the order, i.e. not a general one, covering every paragraph including future listing of the matter. They must also be ordered by the Judge, rather than applied at drafting stage. In defence of committals, a first step should always be to review the Order. On occasions orders make clear there was no intention to apply a penal notice, but one appears due to an error in drafting. On other occasions the transcript will show that a penal notice was never even discussed, but has just arrived through the drafting process. These are all important steps to ensure that a party who listens intently to the court proceedings and complies as best they can, does not suddenly find that they are threatened with contempt of court because they did not then re-read the Court order. In both the prosecution or defence of a contempt application, it is vital that a party ensures they are represented by an experienced lawyer. To often the basics are missed, a failure to complete the forms properly, a misguided application, or just a failure to join the dots, results in an expensive day to court. Advancing into the AI age, I thought I was would ask Chat GPT to tell me about the Debtors Act 1869, an act that many a lawyer has never heard of. Chat GPT informed me that
"The Debtors Act 1869 is an Act of Parliament in the United Kingdom that provides relief to debtors. The main purpose of the Act is to provide a mechanism for the discharge of debt by imprisonment or other means. The Act applies to both England and Wales and Scotland. Under the Act, a debtor can apply to the court to be released from prison if they have been imprisoned for non-payment of a debt. The court can then order the release of the debtor if it is satisfied that they are unable to pay the debt, or if there is no likelihood of them being able to pay it in the future. The Act also provides for the appointment of a trustee or assignee to manage the debtor's property and assets in the event that they are unable to pay their debts. The trustee or assignee can then take steps to recover the debts owed to the debtor. The Act further provides for the setting aside of judgments obtained by fraud or misrepresentation. This means that a debtor can apply to the court to have a judgment against them set aside if it was obtained by fraud or misrepresentation. Overall, the Debtors Act 1869 is an important piece of legislation that provides relief to debtors who are unable to pay their debts, while also protecting the rights of creditors. It remains relevant to this day and continues to provide an important legal framework for dealing with debt-related issues." Clearly, at the moment AI isn't going to replace lawyers in complex issues. AI records that "The main purpose of the Act is to provide a mechanism for the discharge of debt by imprisonment or other means. ", but the first line of the Act records that it is "An Act for the Abolition of Imprisonment for Debt, for the punishment of fraudulent debtors, and for other purposes." The Act ended the Dickinson’s ideas of debt prisons and significantly improved the world for those falling on hard times. Section 4 prohibits imprisonment for debt save where the debt relates to a penalty, other than by contract, a fine before a justice of the peace, default by a trustee to pay a sum to court, default by a solicitor to pay wasted costs order and failure to pay sums deducted from wages. The section provides a term of imprisonment of up to a year, and that such imprisonment does not discharge the debt. Section 5 provides for imprisonment of small sums, owed due to an order of the Court, and then only for six weeks, and again does not extinguish the debt. The debt however cannot be an ordinary debt. As the Court of Appeal in Hussain, this is not as black and white despite the age of the act. Chat GPT, also clearly read the Act as created rather than as it now exists. The summary cannot be complained about, but we are far away from Chat GPT issuing a committal application just yet. The Upper Tribunal Immigration and Asylum Chamber will be closed on the following dates:
Friday 24th December 2021 Monday 27th December 2021 Tuesday 28th December 2021 Monday 3rd January 2022 Between Wednesday 29th and Friday 31st December the office will operate on skeleton staffing. OUT OF HOURS SERVICE If you wish to lodge an urgent application for immediate interim relief during this period, this will need to be made to a duty Judge of the Queen’s Bench Division (acting as a Judge of the Upper Tribunal) to consider. To speak to a member of staff for the out of hours service, please ring 020 7947 6260 (RCJ Security Desk). CE-File case management system (CMS) will be transitioning into the Judicial Review, Upper Tribunal Immigration and Asylum Chamber. It is due to go live from the 17 January 2022.
The introduction of the CMS will allow staff and judiciary in these locations to issue and manage cases electronically, moving away from the current FHINS system. CE-File will remove the need for a paper case file, when mandated for professional users or when a litigant in person chooses to use the external E-Filing service. The case numbers will change from the current format JR/1234/2021 to the new E-Filing format JR-2021-000001 • Scheduling of online training webinars for legal professionals leading up to go-live will be advertised on the Reform GOV.Uk site (www.gov.uk/guidance/hmcts-reform-events-programme), HMCTS social media channels and the HMCTS stakeholder weekly bulletin • The current available GOV.UK guidance to support users: www.gov.uk/guidance/hmcts-e-filing-service-for-citizens-and-professionals & https://www.gov.uk/government/publications/how-to-use-the-hmcts-e-filing-service • Access to all the previous E-Filing training recordings and a recording will be made for the UTIAC specific training to be hosted here: CE File Training Sessions - YouTube The CE-Filling system, has had a mixed response in other areas, with there still being a tendency for some judges to need to be emailed the papers in addition to them being filled. We will need to wait and see how the Tribunal deal with case preparation and whether emailing the bundles, and or hard copies will become a thing of the past. An interesting comparison is to be made between those who seek to protest both by blocking roads, and using social media to allegedly cause trespass and harassment, and those that simply block roads, allegedly causing trespass and nuisance as an act of protest. In MBR case judgment is attached below, the Court concluded that there should be the bare minimum done in the interim to enable protest. A prohibition on trespass, and a zonal order on the space directly in front of the Claimants property. Even that bare minimum had a considerable effect on the protest, but was far removed from the injunction granted in the National Highways case, including against persons unknown. The case also noted the procedural differences where there is an allegation of harassment that relates to publication, and the real need to focus a claim. The National Highways case has received recent publicity, because of the committal proceedings. The underlying order against named and unknown parties provided provided that: "2.1 Blocking, endangering, slowing down, preventing, or obstructing the free flow of traffic onto or along or off the M25 for the purposes of protesting. 2.2 Causing damage to the surface of or to any apparatus on or around the M25 including but not limited to painting, damaging by fire, or affixing any item or structure thereto. 2.3 Affixing themselves ("locking on") to any other person or object on the M25. 2.4 Erecting any structure on the M25. 2.5 Tunnelling in the vicinity of the M25. 2.6 Entering onto the M25 unless in a motor vehicle. 2.7 Abandoning any vehicle or item on the M25 with the intention of causing an obstruction. 2.8 Refusing to leave the area of the M25 when asked to do so by a police constable, National Highways Traffic Officer or High Court Enforcement Officer. 2.9 Causing, assisting or encouraging any other person to do any act prohibited by paragraphs 2.1-2.8 above. 2.10 Continuing any act prohibited by paragraphs 2.1-2.9 above." Interesting a number of the civil prohibitions were also criminal in nature, it is unclear how if there were no criminal prosecution and party could be allowed to prosecute what is otherwise a criminal matter. Oddly term 2.6 seems to suggest that persons are now excluded from riding on a motorbike on the M25, but could drive a milk cart (prohibited by law normally on a motorway), as the order permits it. The terms of the prohibition all seem very odd, and things that are already prohibited by the law. There may well be definitions that get around these issues. However they are on any reading and especially as they are against persons unknown wide ranging and rather specific, for interim relief. Why the same effect could not have been achieved by zonal orders prohibiting protest on the M25 as was done in the MBR case. The committal case also made clear that a Defendant must choose to access legal aid, and that once they were aware of it, that was all that really had to be done. There will be cases in the future, it is clear that will show that in some areas finding a solicitor to act under legal aid, is often an impossible obstacle to accessing legal aid.
The Supreme Court have brought to an end, a long running committal cases, between Nobu Su, and Lakatamia Shipping Company Limited, heard before the High Court between the issue of the application on the 27 March 2020 and the refusal of permission to appeal to the Supreme Court on the 29 October 2021.
The case first came before the Court on the 3 April 2021, before Mr Justice Foxton, to deal with expedition, and other matters 3 April 2020 . The Committal application continued, with an agreed amendment in May 2020, bring in further allegations. Mr Su, declared himself bankrupt, and the process of collection of his debts started. In October 2020, Mr Su was back before the Court in relation to the underlying civil case. Mrs Justice Cockrill described "Mr Su's name will be familiar to any student of modern commercial litigation. He is a gentleman who has gone by various names over the years, including Nobu Su, Su Hsin Chi and Nobu Morimoto. Over the past 10 years Mr Su has been embroiled in a substantial number of civil court proceedings in England and Wales and elsewhere." That judgement described the long and embattled history between Mr Su and the Claimants 30 October 2020 In December 2020, a further amendment, the second was sought. The matter came before Mr Justice Calver, and permission was granted to add the further allegations. 11 December 2020 On the 1 April 2021 on review Deputy ICC Judge Passfield determined that Mr Su was within the Jurisdiction such that he could claim to be bankrupt. In April 2021, it came before Sir Michael Burton, who dealt with issues relating to continuation of the passporting orders, in light of Mr Su, then being found to be bankrupt. 15 April 2021 In June 2021 Mr Su admitted to the contempts, and sought that he was sentenced at the further hearing of the matter. In July 2021 Mrs Justice Bacon determined that Mr Su was not within the jurisdiction for the purpose of bankruptcy, and so determined that his bankruptcy would be annulled. 1 July 2021 on the 7 July 2021, Mr Su having admitted the contempt's, came back before Sir Michael Burton, for the third time to be sentenced. On this occasion Sir Michael determined that the proper sentence for Mr Su, was the maximum sentence of two years of imprisonment, despite mitigation and a guilty plea. 7 July 2021 That sentence was widely reported in the Daily Mail and other newspapers Mr Su appealed to the Court of Appeal on the 8 September 2021, for an appeal before Lady Justice Carr and Lord Justice Arnold, that appeal upheld the sentence, on the basis that it was an exceptional case, and as such despite there being mitigation, a maximum sentence could still be applied. Permission to appeal was refused but it was certified as a point of public importance. 15 September 2021 On the 29 October 2021, the Supreme Court refused permission to appeal bring to an end the litigation in respect to committal. There will no doubt be considerable on going issues relating to the debt and other matters. Scott Moncrieff & Associates, instructing Adam Tear as Advocate, recently represented Preston Haskell in both the High Court and Court of Appeal in respect to the appeal against the finding that Mr Haskell had wilfully not paid his former wife monies owed to her.
Before the Honourable Mr Justice Moor, on the 17 May 2021 Mr Haskell successfully resisted numerous allegations that he had not paid money that was said to be owing to his wife. He was however found to owe £50,000, that he had, had and had not paid to his wife. As such he was sentenced to six weeks imprisonment. That decision was upheld on appeal. The High Court case, was an interesting demonstration, as to why these cases should be approached with caution, prepared properly and supported by a properly prepared witness. The Claimant in the matter, may now have lost her opportunity to enforce by way of the Debtors Act, in respect to the majority of the payments that have so far fallen. The case was widely reported in the Times and the Daily Mail |
AuthorAdam is a solicitor advocate, and regularly appears in the High Court and Court of Appeal dealing with some of the most complex and interesting cases. Archives
May 2024
|