I did it, though. By December 1997 everything was in place and the formal application to the court was made.
Affidavit of Margaret Anne Mintern
Sworn 18.12.1997
1
I am the mother of the defendant herein and make this affidavit in support of our application for an order/declaration that our son Matthew Mintern the defendant herein may lawfully have discontinued all life-sustaining treatment and medical support measures withdrawn.
2
Matthew was born at teatime on Sunday 17 February 1974. He weighed in at 7 pounds twelve ounces after a problem-free and planned pregnancy. Kevin my husband and Matthew’s father was present at the birth. He still rates Matthew’s birth as the best experience of his life. When Catherine our daughter was born some thirteen months earlier he was unable to attend due to work commitments.
3
Matthew was a happy baby and from early on it was clear that he was very bright. He taught himself to tell the time at the age of 4 and was full of questions about the world around him. He was logical and intelligent.
4
At primary school he was popular with his peers, got on well with lessons and loved sport. He captained the school football team and won the victor ludorum in his final sports day. Secondary school was similarly happy. He had full attendance and became Senior Prefect, and in his final year he won the Headmaster’s Prize for Outstanding Achievement, having gained 9 GCSEs, seven of those at Grade A.
5
In his leisure he played football for the same team from the age of 10 to the date of his accident. In his time with the team he won annual awards of Top Goal Scorer, Manager’s Player of the year, and player of the year [voted by the team]. He also loved his pets and would spend hours patiently training his dog to do tricks.
6
Matthew was also very astute with money and purchased some British Gas shares out of his savings. When we bought our business in 1989 Matthew cashed in those shares and invested the £1000 to help with the purchase. He subsequently became a great help in the business, doing the cellar work before going to school, and helping out in the evenings and at weekends. He was popular with the customers, always being ready with a joke or a good story.
7
Matthew did not have a particular career in mind, but planned to study maths, physics and chemistry at Sixth Form College and thereafter to read science of some sort at university. His secondary school teachers suggested that he aim for Oxbridge.
8
During the summer of 1990 he obtained a seasonal job with Fairclough Engineering. They were impressed with him, and said they would fix him up with vacation work whilst he went through college and university.
9
Matthew was superb company, with a very quick sense of humour and a lively mind. He was hardworking and determined and very keen to do well in life. He loved sport both as a spectator, but mostly as a participant; we were enormously proud of him and loved him dearly.
10
Matthew was never to know how well he had done in his exams, because on 12 August 1990, some two weeks before the results came out, he was hit by a car. The first we knew of it was a phone call from Catherine, who had travelled with him in the ambulance. Catherine said to us ‘they say it’s serious, Mum; he’s badly hurt’.
11
We waited together while he underwent emergency surgery, and then the surgeon came to talk to us. He explained to us what he had done and said that it was too early to give a prognosis. The next hours and days would be critical. If Matthew survived then the long-term prospects were not known. The surgeon had seen many people in Matthew’s condition and, in his experience, many recovered but some didn’t. At that time, the surgeon did warn us of the possibility of a ‘vegetative’ outcome. My immediate thoughts were ‘Matthew will be one of the ones who recovers. He is fit, full of determination and loves life. He won’t give up and neither will we.’ Kevin, his father said ‘He wouldn’t want to be a cabbage’ and he and Catherine cried inconsolably.
12
During the next three days Matthew was given drugs to sedate him to allow his brain to rest after the trauma and surgery. When the drugs were stopped we waited eagerly for Matthew to ‘wake-up’. We were not unduly concerned when this did not happen immediately. We were told it could be weeks or even months. Many people told us stories of their loved ones returning from long periods of coma. After a few days Matthew came off the Intensive Care Ward, and shortly after he opened his eyes. We were ecstatic!
13
With the guidance of the experts we did all we could to aid Matthew’s recovery. On the physical side we learnt how to keep his body flexible. We felt we were keeping it in shape for when he would need it again. On the stimulation side we tried everything, aiming to reach all five senses. We spent all day with him, and were eventually able to take him home for weekends.
14
Then his friends gathered and tried to coax him into consciousness. People came to play guitars and sing to him. We tried aromatherapy and reflexology, and even allowed the dog to jump up on him.
15
Despite all the efforts of the professionals and ourselves, Matthew failed to make any meaningful progress. A brain scan was taken, which indicated hydrocephalus, and a shunt was inserted to drain off the fluid. Shortly afterwards the doctors decided to discontinue the epilepsy medication he had been given routinely following a severe head injury.
16
About a month later Matthew had his first epileptic attack. The small amount of progress he had made (occasionally turning his head to a sound) was wiped out. I likened it to a snail climbing up a wall and being knocked off. We went back to square one.
17
This pattern continued. Small gains – the physiotherapist noticed some ‘holding tone’ in his leg, he could swallow a small amount of pureed food – and then an epileptic attack would take it all away, leave his body tight and spastic, and his awareness diminished. My diary entries for 1991 tell the sad story:
27 Feb. Took Matthew on corridors. Drinking really good now. Ribena quite a favourite. Kev got a full litre in during the day. Physio good. Stood on mat, left foot much better – and got right arm onto table. Alan (senior physiotherapist) able to let go at both sides of pelvis – only possible on left before. Another fit at 19.45 – just when we seemed to be getting somewhere.
6 March. Matthew has not recovered from the fit last week and has definitely gone backwards. No longer able to swallow, so completely fed by tube again. Ability to ‘follow’ also lost – eyes quite vacant. It’s like going back 3–4 months.
18
One morning we arrived as usual at the hospital to find the curtains drawn round Matthew’s bed and the staff looking sombre. The doctor explained that Matthew had suffered a bad fit – status epilepticus – and was very poorly. He asked what we wanted him to do. I realized with horror that he was asking whether he should treat Matthew or let him die. Our response was unequivocal: ‘Treat him. He is our loved son. He may yet get better.’ Some time after this incident we asked to have him home permanently. He seemed more settled on the weekends when he was at home. The staff taught us all we needed to know to care for him and he came home in May. My diary entry that day reads ‘A busy month arranging to bring Matthew home. Feel very sad. Have had bereavement without a death. No real change in Matthew’s condition – tube fed entirely – chest much better – eyes not focusing or following, but no longer pulled to right. Right arm severely flexes – may have lost it altogether at elbow and wrist-contractures. Love him with all my heart.’ We built a ground-floor extension and had everything science and technology had to offer: special chairs, lifting equipment, physiotherapy and stimulation equipment, the services of a physiotherapist, occupational therapist and speech therapist. We visited the Royal Hospital and Home at Putney, who specialize in brain injury cases. The senior doctor there said there was nothing more he could suggest; Matthew’s regime could not b
e improved. Did we have space to take some of his patients?
19
Despite all our efforts Matthew did not improve. A brain scan, undertaken to explore the epilepsy, had shown that the brain tissue had shrunk since the last scan. The conclusion was that we could expect no improvement. It occurred to me that all we were doing was not only pointless but potentially harmful. The more we did with Matthew the more likely he was to have a fit. The fits were terrible. He would start with a terrified scream – the only time we ever heard him make any significant sound – then move into a grand mal. After the fit he would have a long period of shaking, overheating, and extreme spasticity, with a pulse rate so fast it could not be counted. We consulted another epilepsy specialist, who tried new medications, but the fits persisted. In discussion with the medical team we decided to change our emphasis to ‘palliative care’ rather than ‘rehabilitation’, with the object of our care being to keep Matthew without pain or distress.
20
During the spring of 1995 I reached a very low ebb. I had been jollying everyone along for so long but realized there was no point to it all. On Matthew’s 21st birthday people brought in cards and presents (What do you give to someone in Matthew’s state? How do you ‘celebrate’ his 21st?) I sat with Matthew and read his cards to him, and opened his presents, knowing that he understood nothing, but keeping up the show for everyone else’s benefit. The school choir came to sing for him, and I had to pretend that he enjoyed it. I felt that I was living a lie. In addition, I was deeply tired. I had given everything to get Matthew back, and it was not to be. I was left with a deep emotional tiredness that no amount of sleep would cure. I was broken. I had no time to dream of Matthew before the injury and each time I awoke it was to face anew the horror of his situation.
21
Awaking one morning after dreaming of Matthew, I realized that if he could see what we were putting ourselves through for the sake of his poor twisted body, he would say that we were crazy. It was then that I first considered transferring him to a nursing home. This was the most difficult decision of all. It represented failure, and I felt ashamed. I had vowed that Matthew would always be cared for at home, and, once I realized he was not going to recover, I wanted him to die at home, surrounded by those who loved him. His care was breaking me, and it was all for nothing. He did not know who he was, where he was, or who we were. Why were we doing it?
22
I visited several nursing homes in the area, and decided the most suitable was in our own village. They knew of Matthew and all we had tried. They had no problem with Matthew having his own private nurse to come in just for him. The home had no vacancies at the time, but when one became available in August we moved him in. Relinquishing the daily care to the nursing home gave me the opportunity to begin to mourn Matthew. His physical removal from our home enabled me to remember the son we had lost; the tall 16-year-old, confident, fit and intelligent. It was then I saw how wrong the current situation was. Matthew would never want to be kept alive in this pitiable and hopeless condition. He had prided himself on his intellect and physical prowess. Now he lay, eyes vacant, food pumped into one end and coaxed out with suppositories at the other, unable to make any communication or know any joy. A living corpse. It was unhealthy and unnatural.
23
After many hours of discussion, Kevin, Catherine and I decided that we should seek permission to discontinue nutrition and hydration. We approached our GP in December 1996 and received his support and approval. We spoke to close family members and Matthew’s closest friends, and everyone thought it was for the best. We approached the owner of the nursing home to put him in the picture, and he informed us that Matthew was quite poorly with a chest infection, and suggested that we wait for a while. Matthew recovered from the chest problem without the intervention of antibiotics, so in the spring of 1997 we approached our family solicitor, Mr Maxton. We asked Mr Myles Gibson to examine Matthew as he was aware of his condition, and we knew and trusted him. For my part I wanted an expert opinion from someone who knew how much we loved Matthew. Mr Myles Gibson was very thorough and very kind, and when his report confirmed Matthew was in a permanent vegetative state we felt ready to move on. On the advice of our barrister we asked Professor Jennett to examine Matthew. He agreed that Matthew was in a permanent vegetative state. Professor Jennett was also very kind, and I felt able to ask him many questions. I wanted to know whether today, 7 years on, doctors could be any more precise on the initial prognosis. Could someone say, on the day of the injury, ‘There is no hope for your son.’ The Professor said that doctors would still not be able to know in the early days how each case would turn out. I also asked him what would actually happen to Matthew if we withdrew nutrition and hydration. He said that in most cases it is a very peaceful process, with full coma occurring after a few days, and death within another week or so. I told him that I had always wanted Matthew to die at home, and he said that other relatives have felt this and have taken the patient home. He said he was very willing to give our GPs any advice they may need. All in all Professor Jennett’s visit took a lot of the uncertainty and fear from me and I felt happy that Matthew after all would be able to die at home.
24
I have known for some time that there is nothing I can do for Matthew to enrich his life in any way. He needs to die. We had hoped it would happen with an infection and without the need to approach the court. But the sad irony is that his poor body, unable to do anything else, seems capable of fighting infection. So we are asking the court’s permission to cease nutrition and hydration so that Matthew can be released from his hopeless state. It is our last act of love for him.
25
If the court agrees we would like to nurse Matthew ourselves with the assistance of the lady who has been his private nurse in the nursing home. Sue knew Matthew before the injury and has been involved in his care since 1992. She has always treated him with the utmost respect and dignity. She is a perfect nurse. We cared for Matthew at home for over 4 years, and still have all the specialist equipment. We have the support of our GPs who themselves have the offer of advice from Professor Jennett. We feel it is fitting for Matthew and best for us if he is able to die at home.
RE M (A MINOR)
The court hearing was scheduled for 16 June 1998 at the Royal Courts of Justice on the Strand. By this time my health had improved a bit and I was living in London with John in a flat on Little Russell Street, just across the road from the British Museum. I wasn’t working – I’d done some temping and admin jobs but hated them all. I couldn’t think of anything I wanted to do and was terrified of going to interviews. My parents were giving me an allowance and had suggested that I shouldn’t worry about my own future until after Matty’s death.
Mum and Dad travelled down on the train the day before and stayed in the President Hotel in Russell Square. That night we all went to the theatre to see Show Boat. I cried through ‘Can’t help lovin’ dat man of mine’, and when I looked over at them I saw that they were too.
John took the day off work to come to the court with us. We were all suited and booted, as they’d say in the pub, but only John looked natural. The rest of us looked a bit ‘dressed-up’. We were nervous, rather overawed, and relieved to see Mr Maxton waiting for us on the steps. He explained that we would meet up with the rest of the legal team inside. As we prepared to go in, Linford Christie arrived for his libel hearing, the one where a bemused Justice Popplewell announced himself unfamiliar with the term ‘lunchbox’, and bounded up the steps ahead of us.
‘Well, if we’re in the same court he’ll get there first,’ said Dad.
We were ushered up a magnificent staircase to an upstairs room. Mum was the plaintiff and waited to be called to give evidence. She was wearing a brown tweed suit that she had bought in Scotland before travelling down to Cornwall for my granddad’s funeral in 1982.
Once inside the court everyone was extremely kind to us. The various judicial people went out of
their way to comment on the level of care Matty had received, that nothing more could possibly have been done. There was no doubt that he was in a Permanent Vegetative State, and that his condition was never going to improve.
The judge was asked whether he would like Mum called as a witness.
‘I don’t think we need put Mrs Mintern through that,’ he said. ‘She has been through enough.’
The judge read his ruling. He agreed that Matty should die. I felt strangely calm as the rather beautifully phrased words washed over me, relieved that here were people who had applied intelligence and empathy to our situation and understood that this was a horrible but necessary duty that we had to carry out to liberate Matty from the prison of his body.
And that was it. We thanked everyone and left the court. We went to the pub across the road, the Royal George, and had a gin and tonic each, and then Mum and Dad set off back to Yorkshire. John and I went out and got drunk.
The court had decided that it was the right thing to do. The only thing left was the doing of it.
All England Official Transcripts (1997–2008)
Re M (a minor)
(Transcript: Harry Counsell)
FAMILY DIVISION
SIR STEPHEN BROWN (P)
16 JUNE 1998
H Lloyd for the First and Second Plaintiffs;
The Last Act of Love Page 11
