LONDON: In a landmark ruling the UK’s court of appeal has overturned the decision of a lower court which declared that Indian-origin teenager Sudiksha Thirumalesh lacked mental capacity to make decisions about her medical treatment. This led to her life-saving treatment being withdrawn.Thirumalesh died aged 19 on September 12, 2023 after her wishes to seek experimental life-saving treatment overseas were denied by doctors at the Queen Elizabeth Hospital Birmingham following a court of protection judgment which claimed she lacked mental capacity.This week, in a judgment at the court of appeal pronounced well after her death, Lord Justice Singh, Lady Justice King and Lord Justice Baker ruled Thirumalesh had the capacity to give or withhold her agreement to medical treatment, including palliative treatment, overruling the court of protection.Her Christian parents ThirumaleshChellamal Hemachandran and Revathi Malesh Thirumalesh, who migrated to the UK from Chennai in 2000, said: “From the moment the court of protection judgment was made, it gave the clinicians the power to do whatever they liked, with no respect for Sudiksha’s wishes and treating her family with contempt. No real effort was made to secure a clinical trial of nucleoside therapy, which might yet have saved Sudiksha’s life. A patient’s right to disagree with her doctors, not to relinquish hope, and still to have her decisions respected, will now be part of Sudiksha’s legacy.”On July 20, 2023 the hospital trust made an emergency application to approve a palliative care plan and for her life-sustaining treatment to be removed.Thirumalesh was adamant she wished to have the opportunity to be considered for experimental nucleoside treatment in America or Canada.Dr Dhruba Bagchi, a psychiatrist at the trust, found she had full mental capacity, as did a second psychiatrist. He told the court: “Sudiksha had a strong view that she would come through one day. That view was informed by her religious faith and the love and support of her family. She was clear she did not want palliative care.” “I want to die trying to live. We have to try everything,” she told him.But the position of the trust was that she was delusional. On Aug 7, 2023 the court of protection made a declaration that Thirumalesh lacked capacity “to give or withhold her agreement to medical treatment”. She died 35 days later.Andrea Williams, chief executive of the Christian Legal Centre, said: “She was the one determined to fight for her life against a system that continually pushed her towards death.”
