From Twilight to Breaking Dawn? Best Interests, Autonomy, and Minimally Conscious Patients M v N [2015] EWCOP 76 (Fam)

In law, as in the alphabet, N comes after M. Like M, whose case was decided in 2011,1 N was in a minimally conscious state (MCS), a disorder of consciousness in which the patient nevertheless exhibits some signs of consciousness.2 The issue in N's case, as in M's, was whether or not clinically assisted nutrition and hydration (CANH) should continue to be provided. The MCS is distinguishable from the permanent vegetative state (PVS), in which sleep–wake cycles are observable, but the patient appears unaware, uncommunicative, and incapable of purposeful behaviour.3 Yet, if the patient occupies either of these ‘twilight world[s]’,4 the court must decide whether or not CANH can be withdrawn.5 In M's case, this treatment stayed in place; in N's case, Hayden J decided that the treatment...