Cost analysis of the legal declaratory relief requirement for withdrawing Clinically Assisted Nutrition and Hydration (CANH) from patients in the Permanent Vegetative State (PVS) in England and Wales

This paper estimates the NHS cost per case of the legal declaratory relief process in relation to withdrawal of clinically assisted nutrition and hydration (CANH) from patients diagnosed as being in a permanent vegetative state (PVS), in relatively ‘straightforward’ cases where family and clinicians agree this is in the best interests of the patient. The PVS declaratory relief process lasts, on average, nine months and costs the NHS about £122,000 per case. This comprises about £53,000 in legal costs and about £69,000 in on-going care costs which we estimate cost just over £7,500 per month.