The Supreme Court has unanimously dismissed the appeal in R (Maguire) v. HM Senior Coroner for Blackpool and Fylde [2023] UKSC 20 finding that there was no arguable breach of Article 2 of the European Convention on Human Rights concerning the right to life.

In this insight we set out below a summary of the key findings. The full judgment can be accessed here and the summary here. 

The facts

Jacqueline Maguire (Jackie) sadly died in hospital in February 2017. She lived in a care home and was subject to a Deprivation of Liberty Safeguards standard authorisation. There were concerns regarding the care provided to her and a decision not to take her to hospital when she became unwell and declined conveyance shortly before her death.

Following conclusion of the evidence at the inquest touching Jackie’s death, the Coroner determined that an expanded conclusion, as required in an Article 2 compliant inquest, was not necessary. It is this decision which has been challenged through the courts. The jury found that Jackie had died of natural causes. 

The Court’s findings

Systems duty

The obligation on the state to have appropriate legal regimes and administrative systems in place to provide general protection for the lives of citizens and persons in its territory.

• There was no arguable breach of the systems duty.
• The State has put in place a regulatory regime designed to ensure that a high standard of care is delivered by health and social care providers and monitored by the Care Quality Commission.
• The systems duty in the context of healthcare services operates at a high level, is relatively easily satisfied, and it will only be in rare cases that it will be found to have been breached.
• Individual lapses (even those which are negligent) do not generally constitute a failure of the Systems duty.

Operational Duty

The obligation on the state to take preventative operational steps to protect a specific person or persons when the state knew or ought to have known of a risk to life.

• Healthcare professionals were not on notice that Jackie's life was in danger on 21 February 2017 when they were called to attend her. On her declining to attend hospital, the level of risk was not sufficient to go against her wishes by forcibly removing her to hospital. She was not denied lifesaving emergency treatment.
• There was no arguable breach of the operational duty.
• When an individual is placed in a care home, a nursing home or a hospital, the State does not assume responsibility for all aspects of their physical health and does not guarantee the adequacy of healthcare provided to them in all respects.
• The operational duty applies in a graduated way depending on the level of risk. There is a need to identify the nature and degree of the specific risk to life of which the State authorities knew or ought to have known needed to be guarded against, as well as what actions the authorities might reasonably have been expected to take to prevent that risk arising.
• The obligation of staff at the care home was to ensure there was access to the healthcare available to all members of the population generally, in the same way that a family could secure access for a vulnerable family member.

What does this mean for healthcare organisations?

This case is helpful confirmation that the high threshold for there to have been an arguable breach of Article 2 in healthcare settings adopted by the courts to date remains good law. It sets out an incredibly clear summary of the law on Article 2 for those needing a refresher and is an important reference for legal arguments at inquests on whether Article 2 is engaged such that a Coroner should hold an enhanced investigation by considering by what means and in what circumstances the deceased died.

How Capsticks can help

Capsticks can help protect your organisation’s reputation and give your staff the support they need in the lead-up to, and during, an inquest. We have one of the largest inquest teams in the country, representing all types of service provider at around 1100 inquests a year.

For further information on the services we can provide please see here.

If you have any queries around what's discussed in this article, and the impact on your organisation, please speak to Georgia Ford, Holly Bridden or Paul Appleton to find out more about how Capsticks can help.