St George’s University Hospitals NHS Foundation Trust v UJ & Ors

Facts

UJ is a 45-year-old man who attempted to take his own life on 24 April 2026 by shooting himself in the head with a crossbow arrow, sustaining a severe traumatic brain injury. He was taken to St George's University Hospitals NHS Foundation Trust, where emergency surgery removed the arrow and an external ventricular drain was inserted. He has since suffered from hydrocephalus, his body being unable to reabsorb the fluid his brain produces, managed until recently by lumbar punctures, a lumbar drain and an external ventricular drain. On 9 July 2026 he was diagnosed with a large pulmonary embolism requiring anticoagulation, which meant lumbar punctures could no longer be used because of the risk of bleeding. The clinical team wished to insert a ventriculoperitoneal shunt, preceded by an inferior vena cava filter, as the only definitive treatment. At a best interests meeting UJ's family made clear they did not support the procedure, and the Trust accordingly applied to the Court of Protection for authorisation, its application maintained neutrally at the conclusion of the evidence. UJ's history included depression and EUPD and two earlier suicide attempts, in 2023 and July 2024. The court had written evidence from Dr A and Professor B and from UJ's aunts and cousin, and oral evidence from Dr A and from UJ's mother, OJ, whose initial support for the surgery had changed. The Official Solicitor, on a fine balance, opposed the application.