An NHS Trust v NM & Ors

In this case an NHS Trust (‘the Trust’) has made an application dated 8 January 2026 for declaratory relief under the court’s inherent jurisdiction concerning the future medical care and treatment of the first respondent, NM, who was born prematurely by emergency caesarean section on 24 October 2025 at 36 weeks and 4 days gestation. She is 13 weeks old. Since her birth, NM has required intensive life-sustaining treatment arising from multiple complex medical conditions. She is being treated on a neonatal intensive care unit. The key issue is whether it is in NM’s best interests for life-sustaining treatment to continue to be given to her, without which, she will sadly die.

The unanimous opinion of NM’s treating clinicians is that her condition is such that continuing treatment is futile and it is in her best interests for life-sustaining treatment to be withdrawn, for palliative care to be provided to her and for her to be allowed to die peacefully.

The children’s guardian supported the position of the Trust.

NM’s parents, the second and third respondents, had opposed the withdrawal of treatment, but in the position statement filed on their behalf for this hearing it was said that whilst they could not consent to the application, for wholly understandable reasons, they would not actively oppose it. However, on the morning of the hearing the parents’ position changed and they wanted NM to remain on life-sustaining treatment for a further period of three months in order for a view to be taken about her progress and life potential.

It was agreed by all parties that I should hear evidence from the parents, Dr D, consultant neonatologist and head of speciality for neonatology within the Trust, and Dr Davies, a consultant in paediatric intensive care, instructed by the children’s guardian as the independent medical expert.

NM’s sister, KiM, attended court with her parents. I decided it would not be appropriate for her to sit in court for the hearing. She had written a letter to me which I had read. She wanted to meet with me if she could not listen to the evidence. It was agreed that I should meet KiM, accompanied by the children’s guardian, prior to hearing oral evidence, not for the purposes of receiving evidence from her, but so I could hear her views expressed to me directly. She spoke very eloquently and passionately about her love for her little sister.

The parents have been married for 23 years and live together with their older daughter, KiM, age 13, at a property in West London. They are of Sri Lankan heritage and Hindu faith. The parents can understand and speak some English, but their first language is Tamil. They were assisted at the hearing by a Tamil interpreter. KM and KiM regularly visit NM in hospital. AM has only left the hospital once during the past 12 weeks. Their devotion and love for NM is unquestionable. It is noted that the expert, Dr Davies, describes KiM as “possibly the most impressive almost 14 year old I have ever met”, and further describes her as “the most impressive advocate for her baby sister”.

NM was born with multiple complex health conditions. Her main diagnosescan be summarised as follows:

A RESPECT form is in place, completed by a consultant on 18 December 2025, with the knowledge of the parents, and which provided that NM would not be reintubated, and would not be provided with CPR or given emergency medications should there be a deterioration in her condition. In the event of an unplanned extubation, only mask ventilation and non-invasive respiratory support would be provided.

The legal principles to be applied on this application are well settled. Following the decision in Re J (a Minor) (Wardship: Medical Treatment) [1991] Fam 33 and Re A (Male Sterilisation) [2000] 1 FLR, the Court of Appeal in Portsmouth Hospitals NHS Trust v Wyatt and Anor [2005] EWCA Civ 1181 set out the essential legal principles as follows:

“In our judgment, the intellectual milestones for the judge in a case such as the present are, therefore, simple, although the ultimate decision will frequently be extremely difficult. The judge must decide what is in the child's best interests. In making that decision, the welfare of the child is paramount, and the judge must look at the question from the assumed point of view of the patient (Re J). There is a strong presumption in favour of a course of action which will prolong life, but that presumption is not irrebuttable (Re J). The term ‘best interests' encompasses medical, emotional, and all other welfare issues (Re A). The court must conduct a balancing exercise in which all the relevant factors are weighed (Re J) and a helpful way of undertaking this exercise is to draw up a balance sheet (Re A)”

The Court of Appeal in Re A (A Child) [2016] EWCA Civ 759 noted at para 31:

“Whilst its application requires sensitivity and care of the highest order, the law relating to applications to withdraw life sustaining treatment is now clear and well established. It can be summed up with economy by reference to two paragraphs from the speech of Baroness Hale in what is generally regarded as the leading case on the topic, notwithstanding that it related to an adult, against the backdrop of the Mental Capacity Act 2005. In Aintree University Hospital NHS Foundation Trust v James [2013] UKSC 67; [2014] AC 591 Baroness Hale said at paragraph 22:- “Hence the focus is on whether it is in the patient's best interests to give the treatment rather than whether it is in his best interests to withhold or withdraw it. If the treatment is not in his best interests, the court will not be able to give its consent on his behalf and it will follow that it will be lawful to withhold or withdraw it. Indeed, it will follow that it will not be lawful to give it. It also follows that (provided of course they have acted reasonably and without negligence) the clinical team will not be in breach of any duty toward the patient if they withhold or withdraw it.”

And at paragraph 39continued:

“The most that can be said, therefore, is that in considering the best interests of this particular patient at this particular time, decision-makers must look at his welfare in the widest sense, not just medical but social and psychological; they must consider the nature of the medical treatment in question, what it involves and its prospects of success; they must consider what the outcome of that treatment for the patient is likely to be; they must try and put themselves in the place of the individual patient and ask what his attitude towards the treatment is or would be likely to be; and they must consult others who are looking after him or are interested in his welfare, in particular for their view of what his attitude would be”.

MacDonald J provided a summary of the principles which apply to a decision whether to continue life sustaining treatment regarding a young child in Raqeeb v Barts NHS Foundation Trust [2019] EWHC 2531 (Admin) at para 116:

“As regards the application by the court of [the] best interests principle in the context of medical treatment to children who are not ‘Gillick’ competent, this is well settled. The following key principles can be drawn from the authorities, in particular Re J (A Minor)(Wardship: Medical Treatment) [1991] Fam 33, R (Burke) v The General Medical Council [2005] EWCA 1003, An NHS Trust v MB [2006] 2 FLR 319, Wyatt v Portsmouth NHS Trust [2006] 1 FLR 554, Re Ashya King [2014] 2 FLR 855, Kirklees Council v RE and others [2015] 1 FLR 1316 and Yates and Gard v Great Ormond Street Hospital for Children NHS Foundation Trust [2017] EWCA Civ 410:

i)

The paramount consideration is the best interests of the child. The role of the court when exercising its jurisdiction is to take over the parents’ duty to give or withhold consent in the best interests of the child. It is the role and duty of the court to do so and to exercise its own independent and objective judgment.

ii)

The question for the court is whether, in the best interests of the child patient, a particular decision as to medical treatment should be taken. The term ‘best interests’ is used in its widest sense, to include every kind of consideration capable of bearing on the decision, this will include, but is not limited to, medical, emotional, sensory and instinctive considerations. The test is not a mathematical one, the court must do the best it can to balance all of the conflicting considerations in a particular case with a view to determining where the final balance lies.

iii)

Each case is fact specific and will turn entirely on the facts of the particular case.

(iv)

In reaching its decision the court is not bound to follow the clinical assessment of the doctors but must form its own view as to the child's best interests.

v)

The starting point is to consider the matter from the assumed point of view of the patient. The court must ask itself what the patient's attitude to treatment is or would be likely to be. Within this context, the views of the child must be considered and be given appropriate weight in light of the child's age and understanding.

vi)

There is a strong presumption in favour of taking all steps to preserve life because the individual human instinct to survive is strong and must be presumed to be strong in the patient (see Airedale NHS Trust v Bland [1993] ACR 789 at 825). The presumption however is not irrebuttable. It may be outweighed if the pleasures and the quality of life are sufficiently small and the pain and suffering and other burdens are sufficiently great.

vii)

The views and opinions of both the doctors and the parents must be considered. The views of the parents may have particular value in circumstances where they know well their own child. However, the court must also be mindful that the views of the parents may, understandably, be coloured by emotion or sentiment. There is no requirement for the court to evaluate the reasonableness of the parents’ case before it embarks upon deciding what is in the child's best interests.

viii)

The court must consider the nature of the medical treatment in question, what it involves and its prospects of success, including the likely outcome for the patient of that treatment.

ix)

Regard must be paid to the rights of the child, in particular her right to life under Art 2 and her right to respect for private and family life under Art 8. Regard must also be paid to the parents’ rights, in particular their right to respect for private and family life under Art 8. In this case, the right of Tafida and her parents to freedom of thought, conscience and religion under Art 9 of the ECHR is also engaged and must be considered.

x)

There will be cases where it is not in the best interests of the child to subject him or her to treatment that will cause increased suffering and produce no commensurate benefit, giving the fullest possible weight to the child's and mankind's desire to survive”

The Court of Appeal has emphasised that views and opinions of the parents do not take precedence. In Yates and Gard v Great Ormond Street Hospital for Children NHS Foundation Trust [2017] EWCA Civ 410, McFarlane LJ observed:

“As the authorities to which I have already made reference underline again and again, the sole principle is that the best interests of the child must prevail and that must apply even to cases where parents, for the best of motives, hold on to some alternative view”

The court must also consider the guidance which has been issued by the Royal College of Paediatrics and Child Health titled “Making Decisions to Limit Treatment in Life-limiting and Life-threatening Conditions in Children: a Framework for Practice”, published in March 2015.

With respect to the issues raised in this case the Guidance states as follows (regarding the sets of circumstances when treatment limitation can be considered because it is no longer in the child’s best interests to continue, as treatments cannot provide overall benefit):

“I When life is limited in quantity If treatment is unable or unlikely to prolong life significantly it may not be in the child's best interests to provide it. These comprise:

A. Brain stem death, as determined by agreed professional criteria appropriately applied;
B. Imminent death, where physiological deterioration is occurring irrespective of treatment;
C.Inevitable death, where death is not immediately imminent but will follow and where prolongation of life by LST confers no overall benefit.

II When life is limited in quality This includes situations where treatment may be able to prolong life significantly but will not alleviate the burdens associated with illness or treatment itself. These comprise:

A.

Burdens of treatments, where the treatments themselves produce sufficient pain and suffering so as to outweigh any potential or actual benefits;

B.

Burdens of the child's underlying condition. Here the severity and impact of the child's underlying condition is in itself sufficient to produce such pain and distress as to overcome any potential or actual benefits in sustaining life;

C.

Lack of ability to benefit; the severity of the child's condition is such that it is difficult or impossible for them to derive benefit from continued life”

In respect of circumstances where life may be of limited quality due to a lack of ability to benefit from continued life, the Guidance provides further detail as follows:

“C. Lack of ability to derive benefit

In other children the nature and severity of the child's underlying condition may make it difficult or impossible for them to enjoy the benefits that continued life brings. Examples include children in Persistent Vegetative State (PVS), Minimally Conscious State, or those with such severe cognitive impairment that they lack demonstrable or recorded awareness of themselves or their surroundings and have no meaningful interaction with them, as determined by rigorous and prolonged observations. Even in the absence of demonstrable pain or suffering, continuation of LST may not be in their best interests because it cannot provide overall benefit to them. Individuals and families may differ in their perception of benefit to the child and some may view even severely limited awareness in a child as sufficient grounds to continue LST. It is important, here as elsewhere, that due account of parental views wishes and preferences is taken and due regard given to the acute clinical situation in the context of the child's overall situation. Although it is possible to distinguish these different groups of decisions to limit LSTs that are based on quality-of-life considerations, in practice combinations may be present. For example, a child or infant in intensive care may have sustained such significant brain injury that future life may provide little benefit, while both intensive treatment and future life are likely to cause the child substantial pain and distress”.

There is also the need to consider the relevant human rights of both NM and her parents, namely Article 2 (“right to life”) and Article 8 (“right to respect for private and family life”).

In her first witness statement Dr D referred to the three attempts to see if NM could breathe unaided. She could not. The events relating to the re-intubation of the child following this third attempt on 8 November 2025 are described as follows:

“On the 8th of November NM had a brief period of cardiac compressions due to her breathing tube blocking off with secretions. NM’s oxygen requirement had increased to 60% and she was requiring higher pressures on the ventilator. There was a large leak between the breathing tube and her windpipe of up to 100%. Due to the concerns about leakage around the size 3mm endotracheal tube, a third intubation was required and happened on 11^th November 2025, to upsize to a size 3.5mm endotracheal tube. A team of 6 Neonatal Consultants was assembled with a variety of difficult airway equipment in preparation to upsize the breathing tube. As she already had a breathing tube in place a bougie was used. A bougie is a firm plastic rod that is inserted into the current breathing tube and remains in place in the windpipe whilst the old breathing tube is removed and a new one is inserted over the bougie into the windpipe. The bougie is then removed. This technique is used when it is known the intubation will be difficult and normal airway equipment cannot be used. Whilst NM was effectively intubated on the first attempt, the procedure was still technically difficult and took longer than an uncomplicated intubation. NM’s saturations (oxygen levels in her blood) became very low at 25% and her heart rate, having been 100-120 beats per minute before the procedure (which was normal for NM), increased to 170 beats per minute with the stress of the procedure and then dropped acutely to 100 beats per minute before recovering without the need for cardiac massage. This demonstrated that the change in breathing tube was stressful for NM and she did not tolerate it well.”

Dr D also addressed the progress of NM’s care from birth to a diagnosis being established for her condition and presentation. She said:

“3.1

It is important to note that initial intubation procedures and the subsequent upsizing of the endotracheal tube were performed prior to the diagnosis of a catastrophic haemorrhagic spinal cord insult, confirmed by MRI on 18^th November 2025. Before a definitive diagnosis was established, the prognosis remained uncertain. The objective was to complete the comprehensive diagnostic pathway under Dr B’s (our Consultant Perinatal Neurologist) guidance, with no limitations placed on the extent of medical management. The MRI on 18th November 2025 established a diagnosis for NM, showed an antenatal, rare, catastrophic haemorrhagic spinal cord insult resulting in quadriplegia and ineffectual diaphragmatic function. There was also white matter injury to the substance of the brain itself. The parents were fully informed about the irreversible injury and very poor prognosis using a face to face interpreter and Tamil speaking clinician.

3.2

On 19^th November 2025 the attending consultant (Dr G) had a meeting with NM’s family to discuss the findings of the scans again, and regarding the management of NM’s future care. The Trust also obtained advice from a different Trust, and approached the neurosurgical team at Great Ormond Street Hospital. They confirmed that no surgical intervention was possible to improve NM’s outcome. The long-term ventilation team at Great Ormond Street Hospital were also contacted and gave the opinion that it would not be appropriate to offer NM long term ventilation. The neonatal team felt at this point that continuing to provide intensive care was not in NM’s best interest and would only prolong her suffering. NM’s parents did not agree with this opinion. Between 19^th November and 26^th November 2025 there were several discussions between attending consultants (Dr B and Dr S Consultant Neonatologists) and parents (all with Tamil interpreters) reiterating the MRI result, diagnosis and prognosis.

The parents continued to disagree with the findings, however the unanimous position of the Neonatal Consultant team and multidisciplinary neonatal team was that considering the established diagnosis, continuing intensive care due to this untreatable extensive neurological damage would be futile and intensive care should stop. The non escalation plan / ceiling of medical management was therefore established, documented in NM’s notes, and communicated to the parents on both 19^th and 26^th November 2025 by attending consultants.

3.3

On the 1^st December 2025 NM’s case was presented and discussed at the Trust Clinical Ethics Committee with parental consent, and whilst this Committee does not make clinical decisions, the Committee was in unanimous agreement for the non-escalation plan to remain in place (not for reintubation or any resuscitation measures offered). The purpose for this Committee meeting was to consider the recommendation of the Neonatal Consultant team and multidisciplinary neonatal team that it was not in NM’s best interests for life sustaining treatment to consider to be given and defined a ceiling for medical management including the decision not for re-intubate. The Committee agreed with this opinion, the ceiling of medical management to be in place for NM whilst the neonatal team initiated the legal pathway for a court judgement regarding the planned withdrawal of intensive care therapy in NM’s best interests. I documented the summary and outcome of this meeting on the 2^nd December 2025.

3.4

Since 1^st of December 2025 NM has remained cardiovascularly stable in the neonatal intensive care unit receiving continuous invasive mechanical ventilation despite the increasing leak around the suboptimally sized breathing tube and infection episodes treated with antibiotics. Additionally, to mechanical ventilation she needs regular suctioning, nasogastric tube feeding and urinary catheter to be in place. However, this situation could change rapidly at any time as with any ventilated patient with a breathing tube that has been in for a long duration, causing her to deteriorate unexpectedly.

3.5

On 18^th December 2025, the Trust obtained a second opinion from Dr U (Consultant in Neonatal Medicine), Chelsea and Westminster Hospital, and who concluded that from her review of NM’s medical history and assessment, that her condition was not compatible with independent survival, that there was no realistic hope for improvement or therapeutic intervention, and that ongoing provision of ventilatory support would merely delay her death and cause her discomfort.”

In her second witness statement Dr D referred to events on 15 January 2026 when NM suffered episodes of desaturation and required suctioning on three occasions to remove secretions within a short period of time. She described the significance of these events as follows:

“As per my previous statement, NM currently has an audible, >90% leak around the size 3.5mm breathing tube during ventilation, and our neonatal team anticipate that due to the suboptimal size of the breathing tube combined with her growth, this will eventually make ventilation ineffective. The events of this afternoon underscore how fragile NM’s condition is and highlight the considerable risk of a sudden and severe deterioration due to her extremely limited ability to tolerate low oxygen levels. In my opinion, this is largely caused by the secretions due to the breathing tube and mechanical ventilation, as opposed to the size of the tube. This has occurred during her previous intubation attempts (please see my Statement of 14^th January 2026, Sections 4.1- 6.3, for a detailed description of these attempts). Should a more prolonged episode of low oxygen occur, this could quickly lead to a significant drop in her heart rate which could be irreversible, ultimately resulting in her death in a manner that may lack dignity, and potentially without her beloved parents by her side.

It is difficult to be certain what impact desaturation has on NM, but the feeling of hypoxia can be distressing. Deep hypoxia for a prolonged period will result impaired/ loss of consciousness and repeat prolonged period of hypoxia can lead to additional brain injury.”

Dr Davies was the independent expert instructed by the children’s guardian. He is a consultant in paediatric intensive care (since 2008), the clinical lead for the East Midlands Paediatric Critical Care Network, and Secretary for the UK Paediatric Critical Care Society. He has very considerable experience in the care and treatment of critically ill babies. In his report he noted:

“NM is at a crossroads. There are only two paths she can take: full intervention, or palliation. Maintenance of the status quo is not a reasonable option, as it condemns her to staying in hospital with suboptimal technical care.

Parents and her sister were very eloquent about how much she means to the family. I understand this and it was an emotional meeting. There is no question that her family loves her deeply. Parents seem to believe that she will get better at an undefined point in the future. There is no described mechanism for this to occur, and goes against the combined expertise of specialists in at least five hospitals around the UK.

Mother expressed to me she “knows” that NM will get better. I suggested to her she “wants” her to get better. It is important to differentiate between these.

We all want her to get better. However, all the evidence is that NM has suffered a truly catastrophic prenatal injury, which is permanent, and has affected her movements and her cognition.

I do not believe that NM will gain enough cognitive function to enable her to benefit sufficiently to overturn the very significant burdens to her care, involving operations, constant painful interventions, deprivation of sensation, deprivation of movement, and loss of dignity.

With a heavy heart, I would therefore advise a palliative care plan for her. I do not think that the burdens of continued treatment are outweighed by the benefits. Therefore continued treatment becomes unethical.

In this I agree with the previous specialist opinions by the local neonatal team, the PICU team via Dr M, the external neonatal second opinion by Dr U, the hospital Ethics committee, and the Great Ormond St Hospital Long Term Ventilation team.

I have read the proposed care plan …. I agree with this plan which has been written with great sensitivity. Her comfort should be prioritised above all. Specifically, I do not think that giving non invasive ventilatory support (CPAP or bilevel (DuoPAP)) is reasonable. This would risk prolonging matters without benefit.

At the current time, despite her large endotracheal tube leak, she is transferrable to another site (hospice or home) for extubation. The options of extubation in a hospice or home are completely dependent on both NM’s stability at the time, and the logistical difficulties which may be encountered. For instance, it would not be reasonable to have to change her endotracheal tube for the purposes of transporting her, with the risks that this entails”

He then said that he had:

“never come across any child during my career with NM’s constellation of physical and cognitive problems who has been given 24/7 long term ventilation”.

The parents were called first to give evidence. The mother and father are obviously utterly devoted to their baby daughter. The mother has rarely left her side or the hospital since she was born. She described how NM reacted to her when she tended to her, fed her or changed her. The mother believed that NM had improved in her condition and presentation since birth and would continue to do so. She pleaded with the court to maintain the current life-sustaining treatment for a further period of three months to enable a better assessment to be made of NM’s prognosis. The father agreed with everything the mother had told me.

I noted, although the parents did not mention it in their evidence, that they had been told by an astrologer in Sri Lanka that in three months’ time their daughter would have fully recovered from her current condition.

Dr Davies confirmed the contents of his report. He made 9 key points:

Dr D agreed with the evidence given by Dr Davies. She confirmed that neither she, her clinical colleagues nor the nursing staff had seen NM smile. She grimaces with pain and discomfort when she undergoes medical interventions. Dr D confirmed that the current treatment regime could not be maintained. In recent days NM had been diagnosed with a urinary tract infection which was being treated with oral antibiotics. Moreover, her need for oxygen via the ventilator had increased which was most likely a sign of the insufficiency of the current breathing tube. Dr D was clear that there was now an urgency in making arrangements for a planned extubation for NM because there was an increasing risk of her suffering an uncontrolled death.

The treating clinicians had agreed a deadline for the withdrawal of life-sustaining treatment at 5pm on 26^th January 2026 which had been set solely for the purpose of giving time to explore the option and to make the necessary arrangements for NM to be extubated at her parents’ home. However, Dr D told me that upon further investigation of the situation, the circumstances of the parents’ home and NM’s condition rendered it unsafe and impractical to attempt to undertake the extubation there. The option of extubating NM at a local hospice had been considered but was not feasible. It was, therefore, proposed that she be extubated in hospital after the parents and KiM had had the opportunity to prepare for NM’s death. After her death, she would then be taken to her parents’ home for up to 7 days for the family to grieve and to undertake religious ceremonies, if this was something that her parents wanted.

There can be no doubt about the enormous great love the mother, the father and KiM have for NM. There can be no doubt about the utter dedication and commitment that they have all demonstrated towards her. They want her to live and to care for her. They do not want her to suffer but believe she will soon improve further and recover. They believe she responds to them and that there have been improvements in her condition.

I have enormous great sympathy for the parents and for KiM. So too do the clinicians and nursing staff who have treated and cared for NM, and as does Dr Davies. I wholly understand why the parents and KiM believe NM has improved and will continue to improve.

They invite the court to refuse the Trust’s application for a period of three months to give NM a chance to make progress and for a further assessment to be then undertaken about her future prognosis. They have been told by an astrologer that in three months’ time their baby daughter will have recovered and will be well.

Unfortunately, the medical evidence is unanimous and is of the clear view that:

I have no hesitation in accepting the medical evidence and in particular the evidence of Dr Davies and Dr D. The care and treatment NM has received has been of the highest order. The decisions made about her day to day treatment, her diagnosis and prognosis have been the subject of the most careful and anxious consideration by the team of clinicians charged with her medical care.

Dr Davies and Dr D were both clear that a delay in making a decision would bring no benefits for NM at all. She will not have made any or any significant progress in three months. A delay would simply increase and prolong the burden of her suffering pain and discomfort on a daily basis. There would also be an increasing risk of her suffering an unplanned and sudden death because of the breathing tube becoming dislodged and/or the insufficiency of the oxygen it is supplying to NM.

In any event, a delay would engender an attempt at replacing the current breathing tube with a larger tube to ensure the adequate provision of oxygen. This procedure would be extremely difficult and complicated for the clinicians to undertake and dangerous for NM to endure, and was not something the treating clinicians were willing to attempt.

The Trust has explored all possible options to enable the withdrawal of life-sustaining treatment to take place in the best environment for NM, for her parents and for her sister. Sadly, it proved impractical and potentially unsafe for NM to be transported to and extubated at her parents’ home. The hospice, considered as an alternative, would not have the necessary support and provision available within the timescale which would be in NM’s best interests. Therefore, it is proposed that extubation will take place in the hospital after all preparations have been made for NM and her family.

I regret I am in no doubt that it is not in NM’s best interests for her to continue to receive life sustaining treatment. It is in the best interests of NM to withdraw all life-sustaining treatment and to allow her to have a peaceful and dignified death. NM will receive such treatment and interventions to ensure she is not in pain or discomfort once the breathing tube has been removed.

A final issue raised by the Trust was the duration of the reporting restrictions order following this hearing. Following the decision of the Supreme Court in Abbasi and Ors v Newcastle upon Tyne Hospitals NHS Foundation Trust[2025] UKSC 15(“Abbasi”) it is clear that injunctions made in proceedings should not, without compelling reason, be open ended. In Abbasi, the Supreme Court upheld a decision to discharge injunctions protecting the identities of clinicians and other hospital staff involved in the care of two children, now deceased, who had been the subject of end-of-life proceedings. It acknowledged that it may be appropriate to continue such injunctions following the death of the child for a limited ‘cooling off’ period. The Trust submitted and I agreed that the terms of the order should continue for 2 months following NM’s death.