A woman has persuaded a judge that her 50-year-old mother - who wants to die because she thinks that she has lost her "sparkle" - is mentally capable of deciding to refuse medical treatment in hospital. 
  
 The woman told Mr Justice MacDonald that no-one in the family wanted her mother to die. 
  
 She said she thought that her mother had made a "horrible" decision. 
  
 But she argued that her mother, who has a grandchild, understood what she was doing and was mentally capable of making decisions about treatment. 
  
 The judge ruled in the woman's favour late on Friday after analysing the case at an eight-hour hearing in the Court of Protection, where issues relating to sick and vulnerable people are considered, in London. 
  
 A lawyer who represented the woman at the hearing today said the "result" was right - but she said there were no winners. 
  
 Solicitor Laura Hobey-Hamsher said the judge had recognised the 50-year-old woman for "who she was". 
  
 The woman's mother had damaged her kidneys when taking a drug overdose in a failed suicide bid and was now refusing dialysis, Mr Justice MacDonald was told. 
  
 Specialists argued she had a "dysfunction of the mind" which made her unable to make decisions about treatment. 
  
 They asked the judge to rule that it would be in her best interests if treatment was "imposed" and restraint and sedation used if necessary. 
  
 But Mr Justice MacDonald dismissed the application. 
  
 The judge said he was not satisfied that hospital bosses had proved that she lacked the mental capacity to decide to refuse dialysis - although he said they had been right to bring the case to court. 
  
 He said he would publish his detailed reasons for his decision in the near future. 
  
 Another judge, who oversaw the case at an earlier stage, had ruled that none of the people involved could not be identified. 
  
 But the London-based King's College Hospitals NHS Foundation Trust, which asked for a ruling, can be named. 
  
 The 50-year-old woman had a number of daughters - including one in her teens - and a grandchild, the judge heard. 
  
 She had faced a number of "problems" before attempting suicide - including failed marriages and financial difficulties, he was told. 
  
 The judge analysed evidence from psychiatrists and medics. 
  
 One daughter told him that her mother's life had "to all appearances" been fairly glamorous. 
  
 And she said her mother did not want to be poor, "ugly" and "old". 
  
 "She has said the most important thing for her is her sparkly lifestyle," said the daughter. 
  
 "She kept saying she doesn't want to live without her sparkle and she thinks she has lost her sparkle." 
  
 The daughter said family members would devastated if her mother died. 
  
 But she added: "We think it is a horrible decision. We don't like the decision at all. But I cannot get away from the fact that she understands it." 
  
 Neither the daughter nor other family members today wanted to discuss the case. 
  
 But Ms Hobey-Hamsher, who works for law firm Bindmans, said: "No child should ever have to persuade either doctors or a court that when her mother says she wants to die, she knows her own mind. 
  
 "What was right was that the court recognised her mother for who she was: a unique individual, able to make her own decision, in her own way, in her own time, and for the reasons important to her." ||||| Media caption Clive Coleman explains the "right to refuse" treatment 
  
 A judge has ruled a 50-year-old "socialite" known only as C, who tried to kill herself, can refuse kidney dialysis treatment and so end her life because she feels she has lost her "sparkle". 
  
 Why has this case received so much attention? 
  
 Because of the extraordinary C. 
  
 Her life had revolved around "her looks, men, material possessions and living the high life", the judgement said. 
  
 She had had four marriages and several affairs and "spent the money of her husbands and lovers recklessly before moving on when things got difficult or the money ran out". 
  
 Last year, C had been diagnosed with breast cancer, but had refused treatment that would "make her fat". 
  
 A long-term relationship had broken down, she had been plunged into debt, and she had tried to kill herself by washing down paracetamol tablets with Veuve Clicquot champagne. 
  
 She had later told her daughters - by whom, despite her quirks, she was held "dear" - she had "royally cocked it up", the court heard. 
  
 The suicide attempt had badly damaged her liver - but with dialysis, her prognosis would be positive. 
  
 In a statement, C's daughter told the court: "Put bluntly, her life has always revolved around her looks, men and material possessions. 
  
 "She understands that other people have failed relationships, feel sad and continue living, but for her, as she has said, she doesn't want to 'live in a council flat', 'be poor' or 'be ugly', which she equates with being old." 
  
 Is this case about assisted suicide? 
  
 Absolutely not. Assisting a suicide is a criminal offence that carries a maximum prison sentence of 14 years. 
  
 This case is about the right of every individual who has mental capacity to refuse medical treatment. 
  
 Sitting in the Court of Protection, which makes decisions on behalf of those who lack mental capacity, Mr Justice MacDonald quoted a statement of the law from an earlier case, which could not be clearer. 
  
 "An adult patient who… suffers from no mental incapacity has an absolute right to choose whether to consent to medical treatment, to refuse it or to choose one rather than another of the treatments being offered," it said. 
  
 "This right of choice is not limited to decisions which others might regard as sensible. 
  
 "It exists notwithstanding that the reasons for making the choice are rational, irrational, unknown or even non-existent." 
  
 So, for example, a Jehovah's Witness who has mental capacity can refuse a life-saving blood transfusion. 
  
 So what was the issue in the case? 
  
 King's College Hospital, in south London, had applied for a ruling from the Court of Protection that C lacked the mental capacity to make decisions about the dialysis treatment. 
  
 The hospital wanted to be able to treat her against her expressed wishes. 
  
 The judge considered the evidence from three psychiatrists, one of whom concluded C was not able to use and weigh up information about her condition and future due to an "underlying diagnosis of histrionic personality disorder and her current circumstances". 
  
 Critically, he also heard from C's daughters. 
  
 In a statement, one said: "'Recovery' to her does not just relate to her kidney function, but to regaining her 'sparkle' (her expensive, material and looks-oriented social life), which she believes she is too old to regain." 
  
 Having considered all of the evidence, the judge decided C did have mental capacity to refuse dialysis treatment. 
  
 Does this case change the law? 
  
 Not at all. The facts may be extraordinary, but the law is clear and unchanged by them. 
  
 However, C's case reminds us of the right each person has to refuse medical treatment so long as they have mental capacity. ||||| A 50-year-old woman who fears that the passing of her youth and beauty means the end of everything that “sparkles” in life has been granted permission to die by the court of protection. 
  
 In a highly unusual judgment published this week, King’s College Hospital NHS Trust has been told that the unnamed woman has the capacity to make up her own mind and is entitled to refuse the life-saving kidney dialysis treatment she requires. 
  
 The decision includes a detailed account of the lifestyle of C, as the woman is known, describing her as “impulsive”, “self-centred”, heavy drinking and four times married. 
  
 But the judge, Mr Justice MacDonald, explained that the principle was the same for any patient. “The right to refuse treatment extends to declining treatment that would, if administered, save the life of the patient,” he said in his court of protection decision. 
  
 “This position reflects the value that society places on personal autonomy in matters of medical treatment and the very long established right of the patient to choose to accept or refuse medical treatment from his or her doctor. 
  
 “Where a patient refuses life-saving medical treatment the court is only entitled to intervene in circumstances where the court is satisfied that the patient does not have the mental capacity to decide whether or not to accept or refuse such treatment.” Intervention, he said, was not required in this case. 
  
 MacDonald continued: “C is a person to whom the epithet ‘conventional’ will never be applied … C has led a life characterised by impulsive and self-centred decision-making without guilt or regret. [She] has had four marriages and a number of affairs and has, it is said, spent the money of her husbands and lovers recklessly before moving on when things got difficult or the money ran out. 
  
 “She has, by their account, been an entirely reluctant and at times completely indifferent mother to her three caring daughters. Her consumption of alcohol has been excessive and, at times, out of control … In particular, it is clear that during her life C has placed a significant premium on youth and beauty and on living a life that, in C’s words, ‘sparkles’.” 
  
 Having been diagnosed with breast cancer, she had taken an overdose with alcohol. She did not die but caused herself such extensive kidney damage that she required dialysis – which she now refused to undergo. 
  
 The judge added: “My decision that C has capacity to decide whether or not to accept dialysis does not, and should not prevent her treating doctors from continuing to seek to engage with C in an effort to persuade her of the benefits of receiving life-saving treatment in accordance with their duty to C as their patient. 
  
 “My decision does no more than confirm that in law C is entitled to refuse the treatment offered to her for her benefit by her dedicated treating team. Nothing I have said prevents them from continuing to offer that treatment.” 
  
 MacDonald analysed evidence from psychiatrists and medics, and from one of the woman’s daughters. One daughter told him that her mother’s life had “to all appearances” been fairly glamorous. She said her mother did not want to be “poor”, “ugly” or “old”. 
  
 “She has said the most important thing for her is her sparkly lifestyle,” said the daughter. “She kept saying she doesn’t want to live without her sparkle and she thinks she has lost her sparkle.” 
  
  
  
 The daughter said family members would devastated if her mother died, but added: “We think it is a horrible decision. We don’t like the decision at all. But I cannot get away from the fact that she understands it.” 
  
 • In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here |||||
What is a one-paragraph summary of the above article?
– Among the more contentious cases in which the right to die has been granted by the courts, this one stands out because, as the BBC puts it, "of the extraordinary C." The 50-year-old British woman, identified only by that initial, has led what the judge describes as a life replete with excess and impulsiveness and free of "guilt or regret" about her choices. Those choices include four marriages, several affairs, reckless spending, and "out-of-control" drinking, reports the Guardian. "In particular, it is clear that during her life C has placed a significant premium on youth and beauty and on living a life that, in C’s words, ‘sparkles,'" writes Mr Justice MacDonald in his now-published decision. What he was weighing in on: whether life-saving treatment could be forced upon her (the BBC emphasizes that the case has nothing to do with assisted suicide). C overdosed on acetaminophen and Veuve Clicquot champagne after learning she had breast cancer, reports the BBC, and though she survived, damage to her organs has necessitated dialysis—and she won't do it. As one of her three daughters explained in a statement to the court, "'Recovery' to her does not just relate to her kidney function, but to regaining her 'sparkle' (her expensive, material and looks-oriented social life), which she believes she is too old to regain." The upshot of the judgment, which the Press Association reports was issued Nov. 13, is that the Court of Protection can't force C to undergo dialysis. King's College Hospital in London had asked the court to weigh in, arguing that the treatment should be "imposed" on her, even if it meant drugging her into a complacent state to do so. But the judge found she had the mental capacity to make her own choice, a decision that her own daughter called "horrible" but publicly supported in court. (Read why this healthy woman ended her life.)