High Court Rules to End Life Support for Brain-Injured Roofer After Family’s Appeal Fails

Relatives of a 20-year-old roofer, Andy Casey, who sustained a brain injury during a pub garden altercation, faced a heartbreaking setback in their quest to continue his life-support treatment.

A High Court judge, Mr Justice MacDonald, ruled against their wishes, stating that medical professionals can legally discontinue treatment for Mr. Casey, who hails from Mitcham, south-west London.

Specialist opinions indicate that Mr. Casey’s brain-stem function has ceased, rendering him medically deceased.

Medical Professionals’ Assessment

The case revolved around the hospital trust responsible for Mr. Casey’s care, St George’s University Hospitals NHS Foundation Trust, based in Tooting, south London.

The trust sought a declaration that Andy Casey’s brain-stem function had indeed deteriorated to the point of death, allowing them to lawfully halt artificial ventilation and care.

Two specialists conducted brain-stem testing, which, according to Barrister Abid Mahmood, demonstrated that Mr. Casey had passed away.

Family’s Desperate Hope

Despite the medical assessment, Mr. Casey’s family held onto hope, believing they had observed signs of life and movement.

His sister, Christine Casey, passionately expressed her disbelief in the brain-stem death diagnosis.

In response to the judge’s ruling, she voiced her anger and frustration.

The family’s perception of Mr. Casey’s responsiveness to pain and their interpretation of his movements clashed tragically with the medical determination.

Judge’s Difficult Decision

In delivering his verdict, Mr. Justice MacDonald acknowledged the profound sorrow felt by Mr. Casey’s family and friends.

He emphasized that the court’s role was to assess whether Mr. Casey had legally crossed the boundary between life and death.

Despite the family’s understandable hopes and emotions, the judge noted that certain reflexes could persist even after brain-stem death, potentially misleading loved ones.

With a heavy heart, Mr. Justice MacDonald confirmed the date of Mr. Casey’s death as July 16, 2023, at 11:51 pm, in line with medical findings.

He extended his sympathy to the grieving family, recognizing the immense tragedy they were enduring.

Potential for an Appeal

Andy Casey’s sister, Christine, expressed the family’s intention to appeal the judge’s decision.

She highlighted video footage demonstrating her brother’s movements and reactions to pain, questioning how someone with such responses could be considered dead.

The family’s determination to challenge the ruling reflects their enduring hope and emotional turmoil.


This tragic and emotionally charged legal case underscores the challenging decisions faced by medical professionals and the courts in cases involving brain injuries and brain-stem death.

The clash between medical assessments and the perceptions of a patient’s loved ones highlights the complexities surrounding end-of-life care.

While legal decisions are grounded in medical evidence and standards, the emotional toll on families is undeniable.

The potential for an appeal further emphasizes the profound impact of these difficult situations on individuals and their loved ones.

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