Eighty-Nine-Year-Old Is Suffering Significant Pain And Wants NHS Doctors To Respect Her Right To Refuse Treatment

An 89-year-old woman is taking legal action after an NHS trust refused to de-activate her heart pacemaker and respect her right to refuse medical treatment.

The woman, from Hampshire, who wishes to remain anonymous, is in significant pain and distress and has made repeated requests to have her pacemaker de-activated at the hospital run by Frimley Health NHS Trust. She also suffered a serious fall in October 2021 and now requires 24 hour-nursing care. Clinicians at the Frimley Park hospital have refused her request to turn off her pacemaker and respect her wishes.

She and her family, who support her decision, have now instructed the specialist public law and human rights team at Irwin Mitchell to ask the Trust to reverse its decision and undertake the simple non-invasive procedure to de-activate the device. Once the pacemaker pacing function is de-activated the woman will continue to live but if or when her heart subsequently fails it will not be supported by the pacemaker.

Her lawyers have now written to the Trust setting out that she has the legal right to refuse medical treatment and not adhering to her wishes is a breach of her basic human rights. They point out that she has been deemed to have the capacity to make her own healthcare decisions and the law is clear that an adult with capacity has an absolute right to refuse treatment. Maintaining an active pacemaker is active treatment.

The NHS Trust could face urgent High Court proceedings if it continues to refuse to de-activate the device.

Expert Opinion

"This is not about assisted suicide or pro-active euthanasia treatment, this is about a woman who is currently suffering significant pain wishing to choose her treatment as she nears the end of her life. At the moment she is undergoing active treatment from the NHS that she doesn’t want which is causing her significant distress.

In other countries de-activating pacemakers is quite common and the law is clear on patients’ rights. Every patient under NHS care has the right to refuse treatment but in this case the NHS Trust is refusing to comply with the woman’s requests which are also supported by her family who want to see her wishes respected.”
Yogi Amin - Partner and National Head of Public Law and Human Rights

In October 2021 a clinician carried out an assessment and concluded that the woman does have the mental capacity to make the decision and that she has a clear wish for her pacemaker to be turned off as she remains anxious and distressed about her quality of life. She also understands the potential consequences but does not wish to use the pacemaker to prolong her life further given her current suffering.

What is an ICD and Pacemaker?

There are two main types of heart device fitted in the UK, an Implantable cardioverter defibrillator (ICD), which shocks the heart back into action if it stops; and a pacemaker which regulates the heartbeat by sending a signal to the heart if the beat slows or speeds up.

While it is common to turn off an ICD during end of life treatment to prevent terminally ill patients being resuscitated against their wishes, de-activating pacemakers is not widely reported. A pacemaker does not keep a person alive by itself, it just helps their heart to beat more regularly by sending a signal if it slows or speeds up.

The case raises wider and significant questions about what thousands of patients are told when the heart pacemaker is fitted about whether they have a choice to have the device de-activated.

Find out more about Irwin Mitchell's expertise in handling public law and human rights cases