The family of Robert Barnor, a 68-year-old Christian husband and father who died after his life-sustaining dialysis was unlawfully withdrawn by an NHS Trust, will continue their fight for justice at the UK Supreme Court.
In a rare development, the Supreme Court has granted permission to both the family and Epsom and St Helier University Hospitals NHS Trust to appeal in the case of Townsend v Epsom and St Helier University Hospitals NHS Trust.
The case raises profound questions about the rights of incapacitated patients and their families when life-sustaining treatment is withdrawn or withheld during a dispute with doctors.
Mr Barnor’s family are asking the Supreme Court to rule on whether the Court of Appeal was wrong not to order urgent interim protection under section 48 of the Mental Capacity Act 2005 — in practical terms, whether dialysis should have been reinstated while the case was still before the courts.
The Trust, meanwhile, is seeking to overturn the Court of Appeal’s ruling that an NHS body must apply to the Court of Protection where there is a dispute over medical treatment, including life-sustaining treatment, even where clinicians say the treatment is clinically inappropriate.
The Trust had argued and the Court of Appeal had accepted that the court does not have power to order doctors to act against their professional judgment even where this will lead to the death of a patient, and where the case on the lawfulness of the treatment is pending before the courts.
The Trust is supported in its appeal by the Secretary of State for Justice and Lord Chancellor, the General Medical Council, The Health Secretary, The Official Solicitor and The Royal College of Physicians.
The result is a rare two-stranded Supreme Court appeal: the NHS is seeking to reverse a landmark ruling requiring court scrutiny in disputed end-of-life cases, while the family is seeking to establish that urgent life-sustaining treatment should be maintained while the courts decide whether it is in the patient’s best interests.
The appeal will provide an important opportunity for the UK’s highest court to clarify the law on disputed life-sustaining treatment, the role of the Court of Protection, and the emergency protection available to mentally incapacitated patients.
In a further unusual development, the Supreme Court has ordered that the Trust must pay the family’s reasonable costs of responding to the Trust’s appeal and of bringing their own appeal. This means the NHS will pay the family’s Supreme Court costs whether it wins or loses.
The hearing is expected to take place in January 2027.
What happened to Robert Barnor?
Robert Barnor was taken to hospital on 7 April 2025 after collapsing at home following a stroke. He suffered further strokes and remained in hospital. Due to kidney failure linked to pre-existing diabetes and acute kidney injury, Mr Barnor required renal replacement therapy and twice-weekly dialysis.
However, his family believed they saw signs of awareness and improvement, including eye-tracking, hand-squeezing, blinking on request, reacting to music and pointing when he needed help.
Due to his neurological condition improving, he was successfully weaned off life supporting ventilation in July 2025.
However, the doctors told the family that because of severe brain damage suffered it was in his best interests to die. They threatened to take the family to court unless they agreed to a withdrawal of treatment.
An intensive care consultant allegedly told the family: “I regret keeping him alive at the start.”
From July 2025, the hospital resisted the family’s requests to provide medical records and brain scans to substantiate that view, or to obtain an independent opinion from a neurologist.
The hospital also refused the family’s requests to discharge Mr Barnor home, to transfer him to a care home, a neuro-rehabilitation centre, or to move him from the Intensive Care Unit to a specialist renal ward.
The family and the hospital agreed to engage a professional mediator to resolve their dispute, and were in the process of agreeing a suitable date in February 2026.
In a dramatic volte-face, however, on the 6 February 2026, the family were urgently summoned to a meeting with two intensive care consultants and a kidney consultant who announced they had taken a “clinical decision” to terminate Mr Barnor’s dialysis and allow him to die in the next few days, without either reaching an agreement with the family or making an application to court.
In an earlier case, An NHS Trust v Y [2019] A.C. 978, the Supreme Court gave guidance to doctors that it was permissible to stop treatment if the family agreed, but: “If a dispute has arisen and cannot be resolved, it must inevitably be put before the Court.”
However, in a formal letter from its solicitors on 11 February, the Trust confirmed its “clinical decision” to stop providing dialysis after that date, in the expectation that Mr Barnor will die within several days.
Court of Appeal ruled hospital acted unlawfully
Mr Barnor’s family urgently sought legal help and, supported by the Christian Legal Centre, the family instructed lawyers to take the unusual step of making their own urgent application to the Court of Protection for a declaration that continuing treatment was in Mr Barnor’s best interests. Such applications are usually brought by NHS Trusts against families.
The family’s legal team argued that the distinction between a “clinical decision” and a decision to withdraw life-sustaining treatment was artificial and legally meaningless. They submitted that any decision which may result in the end of a patient’s life can only be lawful if it is either agreed with the family or authorised by the court.
However, on 17 February 2026, the Vice President of the Court of Protection, Mrs Justice Theis, refused permission to bring proceedings on the basis that the Court had no power to interfere with clinical decisions as opposed to best interests decisions made by doctors. The family appealed.
Following a hearing on 23 February 2026, the Court of Appeal, Lord Justice Newey, Lady Justice Asplin and Lord Justice Baker, allowed the family’s appeal and remitted the case to another judge for an urgent hearing to determine whether restarting dialysis was in Mr Barnor’s best interests.
The Court of Appeal ruled that, in the absence of full agreement between the doctors and the family, the Court’s permission is required before the NHS can lawfully withdraw or refuse life-sustaining treatment from a mentally incapacitated patient.
Giving the unanimous judgment of the Court, Lord Justice Baker declared:
“The hospital cannot pre-empt court proceedings by unilaterally withholding or withdrawing treatment on ‘clinical’ grounds.”
He added:
“The course taken by the Trust in this case was contrary to established principle and practice articulated in the case law, the Code of Practice, and guidance.”
The judgment further stated:
“Any decision about the care and treatment of a mentally incapacitated adult, including the withdrawal of life-sustaining treatment, must be taken in the patient’s best interests. There is no carve out for ‘clinical decisions’.”
The Court of Appeal held that St Helier Hospital had acted unlawfully, but the court refused to order the hospital to restart dialysis pending the conclusion of legal proceedings by withdrawing Mr Barnor’s life-sustaining dialysis without the family’s agreement and without authorisation from the Court of Protection.
The ruling resolved a major legal controversy by confirming that life-and-death “clinical decisions” to refuse or withdraw treatment are still subject to the best-interests jurisdiction of the Court of Protection.
However, the judgment came too late for Mr Barnor. He died on the morning of 27 February 2026, only hours before a judge was due to decide whether dialysis should be urgently reinstated.
The proceedings were subject to significant reporting restrictions throughout, anonymising Mr Barnor and all members of his family. These restrictions were only relaxed after Mr Barnor’s death, finally enabling the family to discuss the case publicly.
Following the Court of Appeal ruling, Mr Barnor’s daughter Lesley Barnor Townsend, again supported by the Christian Legal Centre, also threatened urgent High Court action against the Faculty of Intensive Care Medicine after it issued a public announcement which the family’s lawyers argued risked encouraging doctors to ignore the Court of Appeal judgment.
After the legal threat, the Faculty removed its original announcement, deleted social media posts and issued a revised statement acknowledging that the Court of Appeal’s ruling is binding law which must be understood and applied accordingly.
The family said the episode showed why clear Supreme Court guidance is urgently needed to protect vulnerable patients and families caught in disputes with hospitals over life-sustaining treatment.
‘This is about whether the NHS can run down the clock’
Lesley Barnor Townsend, Robert Barnor’s daughter, said:
“My father’s life was taken out of the hands of his family and out of the hands of the court. The hospital stopped the dialysis he needed to live, and by the time the courts were ready to look at the issue, he had died.
“This case is now about whether other families will be protected from what happened to us. If the NHS decides to withdraw life-sustaining treatment, and the family objects and goes to court, the patient must be kept alive while the court decides.
“The NHS should not be allowed to run down the clock. A family’s right to go to court is meaningless if the treatment is withdrawn before a judge can rule.
“We are grateful that the Supreme Court will hear our appeal. It is too late to save my father, but it is not too late to protect other fathers, mothers, husbands, wives and children.”
‘A landmark case for every family in the country’
Andrea Williams, chief executive of the Christian Legal Centre, said:
“This is a landmark case for every family in the country.
“The Court of Appeal was right to say that hospitals cannot simply label the withdrawal of life-sustaining treatment a ‘clinical decision’ and thereby avoid court scrutiny. Where a family disagrees, and where life is at stake, the courts must be involved.
“But the family’s appeal raises an equally urgent question: what happens while the court process is underway? If dialysis, ventilation, nutrition or other life-sustaining treatment is withdrawn before a judge can hear the case, the legal process becomes meaningless.
“Robert Barnor died hours before the court was due to consider reinstating dialysis. The Supreme Court must now decide whether patients should be kept alive while the NHS and the family are in court over whether treatment should continue.
“It is highly significant that the NHS Trust has been ordered to pay the family’s Supreme Court costs. This family should never have had to fight alone against the withdrawal of their father’s life-sustaining treatment.
“The Christian Legal Centre will continue to stand with the Barnor family as they seek justice for Robert and protection for other vulnerable patients.”