London - A man has chosen to die of a serious illness rather than accept treatment that would limit his social and sex life, a British High Court judge has said.
The 34-year-old, who is currently sedated on an intensive care ward, has told doctors he does not want to live if the surgery that would keep him alive leads to disfigurement or the loss of independence.
His choice not to live with a stoma – a surgical hole in the stomach with a bag to cope with digestive waste – was disclosed by Justice Hayden in a ruling in the Court of Protection on Thursday.
The patient – whose identity may not be revealed until three months after his death – was described as handsome and meticulous in his appearance. According to Justice Hayden, his step-sister had "gently suggested that he might have been prone to more than a little male vanity".
WATCH: Living life to the full with a stoma
He is said to have suffered more than a decade of painful and complex abdominal problems. In July 2013, he had a gastric ulcer and underwent a laparotomy – which involves a surgeon making one large incision in the abdomen.
The patient also experienced bleeding from the bowel, chronic abdominal pain and poor absorption of nutrients.
He was fitted with a stoma last October but apparently "loathed life" afterwards and had it reversed last month.
He returned to hospital with "significant pain" and sepsis a few days later.
The judge said: "Many people require a stoma to be fitted and... the vast majority make the necessary accommodations to ensure that it does not unnecessarily inhibit their enjoyment of life or become an impediment to their personal and sexual relationships. However, this was simply not the case with this young man. There is powerful evidence that as a young man in his thirties who, as his sister has said, 'knew he was good-looking', he could never accept life with a stoma."
He added: "No amount of support, love or understanding could change his mind. The stoma, it seems to me, ran entirely contrary to his perception of who he is. Its existence was corrosive to his self-esteem." The court ruled that the man should be allowed his wish to refuse medical treatment.
While doctors believe he is likely to survive the removal of the ventilator he is using, the withdrawal of artificial nutrition will inevitably bring death.
The patient has complained of "violent and frightening" dreams while under ventilation in intensive care. His written request for treatment to be withdrawn has set down music to be played to him while he is in a coma, which includes The Smiths and Samuel Barber’s Adagio for Strings.
Justice Hayden said that the man had rejected life with a stoma and had been just as clear in rejecting artificial prolongation of his life. The judge said: "The quality of his life and his mobility has desperately reduced.
"He has made a practical, utilitarian calculation that life in these circumstances is not what he wants. In a real sense this is not a case about choosing to die, it is about an adult’s capacity to shape and control the end of his life."
There is powerful evidence that as a young man in his thirties who, as his sister has said, “knew he was good-looking”, he could never accept life [after surgery]