In the UK, totalitarian judge rules that disabled man must be killed

 It's been a long time since I posted on this blog about any life issue. This post is a more searchable, permanent version of a recent Facebook post.

This case in the UK is very disturbing. While I know there are many cases both in the US and in the UK where people are dehydrated to death, that should never make it so commonplace that we are ho-hum about it. 

And there are aspects of this case that are deeply troubling even beyond the central fact that a judge has ordered this man dehydrated to death. And who asked the judge to rule on the matter anyway? I’m guessing, some doctors or caregivers at the nursing home.

First of all, there isn’t controversy among family members in this case. Fahim’s mother, Farah, was caring for him in her own home when she was ordered in 2025 to put him in a nursing home (by an ironically named "court of protection"), allegedly so that a neurological evaluation could be carried out. But what was allegedly going to be temporary has ended up being permanent, even fatal. 

On one occasion he had aspiration pneumonia in the nursing home, and his mother insisted on calling for emergency help. His oxygen sats were low, and he would have died. He survived that but the care home, plausibly in retaliation, ordered that she not be allowed to see him thereafter, so she was kept away from him for 16 months. His condition deteriorated during that time, she attests.  

So think about this: She was caring for him full-time, then ordered, by a court, to put him into a care home, but not because she was neglecting him in any way. Then they didn’t take good care of him at the home, and she insisted on getting help for him when he would have died of pneumonia. Then she was blocked from seeing him for a long time. The intersection of “private” and “government” here is very troubling, because ostensibly the care home is “private property” so they can just allege that a relative is troublesome or whatever and can block her from visiting her son, even though she was forced to put him in the home by public authority in the first place.

Now, for no other reason than the profundity of his disability, a judge has ordered his nutrition and hydration withdrawn. He’s allegedly in a “vegetative state” with no possibility of recovery; the judge says he has no “comfort or pleasure” in his life and cannot communicate.

The mother alleges that he is not in a “vegetative” state and might even regain some function with proper therapy, but frankly, that shouldn’t matter. We shouldn’t have to argue that. The judge’s own rationale is simply stating that if you’re profoundly cognitively disabled enough, you should be killed by withdrawal of nutrition and hydration. (“Darn, he didn’t die of pneumonia in the nursing home. Well, let’s make sure he dies now!”)

 One wonders whether this could happen in the U.S., legally. Disclaimer: I am not a lawyer, and state law varies! The original order to put him in the care home for neurological evaluation seems to me a possible place where this might not be possible under the legal regimes in U.S. states, though it would be a matter of state law. I’m told that generally family members have more say-so on the care of the cognitively disabled in the U.S. than in the UK. If the mother had the equivalent of a durable power of attorney for healthcare, recognized in Michigan at least, and if there was no allegation that she was abusing the patient or not able to care for him properly, I would hope that in the U.S. she couldn’t be ordered to put him in a nursing home. But then again, not everybody has filled out a DPA for healthcare, which gives another named person the authority to make healthcare decisions for them in case of incapacity.

As for blocking your closest relative from seeing you, in principle, I suspect a nursing home in the U.S. could punish a patient advocate for doing the job of advocating for the patient by alleging that the person was disruptive and by getting a no contact order put in place. It sounds from the story as if such blatantly wrong blockings are becoming increasingly common in the UK and can be put in place at the whim of the homes when they don’t want interference or negative reporting on their treatment of patients. 

Perhaps if one had multiple levels of patient advocates set up in a legal document, the next-level one could still visit and try to watch over one’s care, but if the nursing home were determined to block anyone questioning their care, presumably the same thing could just happen again.

Certainly during C*v*d, there were long stretches during which everybody was blocked from visiting nursing home patients, including their closest relatives and/or legal advocates. There is a group currently trying to get both state and federal laws passed ensuring that at least one “essential caregiver” is permitted to visit a patient during any subsequent epidemic, but this has been successful in only some states as yet. (We don’t have one in Michigan.) So what a home could do might depend on the surrounding circumstances and whether visits were permitted for anyone.

If this judge’s order that Fahim be dehydrated to death is as relatively spontaneous as it appears (presumably issued in response only to a request from the nursing home itself), this is another place where I don’t know if this could happen in the US, especially if you had a durable power of attorney for healthcare set up. Unless that were explicitly set aside by a court and someone in the nursing home were given healthcare decision authority, or unless there were intra-family disagreement, one would think there would not be someone with standing to ask the court to make this decision.

 Another point: The judge doesn’t seem to be alleging that Fahim left orders that this is what he would want under the circumstances. It looks like they are not even bothering with the whole façade of “carrying out the wishes of the patient” but just imposing this on the situation because the nursing home and the judge think Fahim is better off dead. Well, there are situations in state law in the U.S. where what governs the treatment of incompetent patients is not the alleged wishes of the patient but the “best interests” of the patient. Stated that broadly, that isn’t necessarily a bad thing. But when it goes in the direction of saying that the best interests of the patient dictate that he be systematically dehydrated to death, because he’s too disabled, something is very, very wrong.

 And then, the final insult: The gag order. Farah is violating a court order by even speaking out about what has happened. Even in Terri Schiavo’s case they didn’t do that.

 At multiple points here, despite being a bit of an amateur legal geek about such matters, I suspect but don’t know for certain that this exact scenario would not happen in the U.S. as of now. Regardless, it is happening to Fahim and Farah, and the machinery that set the situation up appears to be pretty routine in the UK. 

We should pray for Fahim and his mother. And I would encourage everybody who doesn’t want to be dehydrated to death, even if you are elderly or disabled, to set up a DPA for healthcare according to the laws in your state and make it explicit that you don’t want that to happen. We can at least try to put legal barriers in the way of the appalling machinery of death.