Anyone who looks after a vulnerable relative at home bears a heavy burden of both moral and legal responsibility. The Court of Appeal made that point in the case of a severely disabled woman who died in shocking circumstances after her brother neglected her care and failed to call for medical assistance.
The woman suffered from a number of serious medical problems, including a form of multiple sclerosis, but had made it clear to her loved ones that she did not want to be admitted to hospital. Increasingly immobile, she had for some years been largely confined to the home where her brother and elderly father looked after her.
After an ambulance was called to the house, her body was found on her bedroom floor, surrounded by filth. Severely emaciated, she weighed less than five stone. She had numerous deep and infected pressure sores and 12 pain-killing patches were found on her body, each of them containing a potentially fatal opioid dose.
Her brother explained that she had fallen about two weeks previously and that he had been unable to put her back on her bed. He said that he thought she was getting better and that he could not call for medical assistance because he had promised her that he would not cause her to be admitted to hospital.
Following a trial, the brother was convicted of manslaughter by gross negligence. In sentencing him to a three-year prison term, the trial judge acknowledged that it was not a case of callous disregard. He loved his sister but had buried his head in the sand and clung to an unrealistic hope that she would somehow pull through.
In finding that the case fell into the medium category of culpability, the judge noted that the brother was of previous good character and had his own health difficulties, including a recurrent depressive disorder and agoraphobia. He had managed in the past but was ill equipped to contend with his sister’s increasingly complex care needs. When she ended up on the floor, he was utterly out of his depth.
Dismissing his appeal against the length of his sentence, the Court noted that his sister was on the floor for several days before her death became inevitable. Her excruciating pain would have only been partially alleviated by the opioid overdose. Her brother had abandoned his previous loving care for her and, as her condition inexorably deteriorated, he had not taken even basic steps to discharge the duty of care he owed her.