'I watched my sister slowly die — after doctors withdrew her food in hospital'

'I watched my sister slowly die — after doctors withdrew her food in hospital' After retired secretary Marjorie Evans suffered a stroke, she was taken to the NHS' Royal Glamorgan Hospital in south Wales where medics decided she was unlikely to recover A grieving brother who watched his sister slowly deteriorate over the course of a month after doctors decided not to provide artificial nutrition is calling for families to be given a greater say in medical decisions when loved ones lose the capacity to speak for themselves. Marjorie Evans, 79, suffered a devastating stroke that left her unable to eat, drink or communicate. She was taken to the Royal Glamorgan Hospital in south Wales, where doctors determined that the damage caused by a brain haemorrhage meant she was unlikely to recover. But her brother, Brian Sides, 74, believes more could have been done to keep her alive and has accused medical staff of effectively starving her to death. Marjorie was assessed as unsuitable for a nasogastric (NG) feeding tube, which delivers nutrition directly into the stomach through the nose. Doctors cited concerns that she might inhale the feed, known as aspiration, or pull the tube out if she became distressed. Medical staff concluded that providing artificial nutrition was not in her best interests. Just eight days after her admission, on October 1, 2025, doctors recommended stopping attempts to administer treatment and moving her onto an end-of-life care plan focused on comfort and symptom management. Brian, a retired computer programmer from Bridgend, south Wales, said he spent weeks watching his sister become increasingly weak before she died on October 27. He believes her condition may have improved and insists alternative ways of providing nutrition should have been explored. He now wants changes to the law to give families greater involvement in decisions about withdrawing artificial nutrition and hydration, particularly when patients lack mental capacity. He also wants families to have quicker access to the Court of Protection when they disagree with medical decisions. Speaking about his sister's final weeks, Brian said: "Marjorie might have recovered, there's now no way of knowing. I feel she wasn't ready for end-of-life care, she could've gone to a hospice. "They had made up their mind right at the beginning, but all the problems or risks they mentioned had solutions. I couldn't get anyone to acknowledge the risk of malnutrition. Surely that's just common sense. We as a family have all been shocked and distressed at what has happened. I believe she could have been fed." Marjorie, a widow and retired secretary, had been living in a care home when she suffered the stroke. She was rushed to hospital on September 24, 2025, where investigations revealed a brain haemorrhage had caused extensive damage. Brian said doctors told him an NG tube could not safely be fitted because Marjorie was moving around and might attempt to remove it when distressed, potentially increasing the risk of infection. During a meeting with her medical team on October 1, the family was told that her condition was not expected to improve and that the focus should shift to keeping her comfortable. But Brian disagreed with the decision, arguing that withholding nutrition would only make her weaker. He also claims he noticed signs of improvement, including Marjorie beginning to open her eyes and becoming more responsive to touch. Despite these observations, the decision not to provide artificial nutrition remained unchanged. Brian said different doctors and clinicians gave him different explanations for refusing to fit a feeding tube or provide nutrition through other means. He contacted the hospital's Patient Advice and Liaison Service (PALS) and submitted formal complaints, challenging the treatment plan. The family also faced difficulties obtaining legal authority to make decisions on Marjorie's behalf. Her eldest son applied for deputyship, but Brian said the process was taking too long. There was no Lasting Power of Attorney (LPA) in place, meaning no one had been formally appointed to make health and welfare decisions for Marjorie if she lost capacity. The hospital eventually applied to the Court of Protection to resolve the disagreement over her care. However, Marjorie died before the matter could be considered by the court. Under the Mental Capacity Act 2005, where someone lacks the capacity to make their own medical decisions and has not appointed an attorney, healthcare professionals are responsible for determining what treatment is in that person's best interests, taking relevant circumstances and views into account. Following Marjorie's death, Brian submitted a further complaint on November 1, accusing the hospital of effectively reintroducing elements of the now-discontinued Liverpool Care Pathway for the Dying Patient (LCP). He argued that doctors should have explored alternative methods of providing nutrition, including a percutaneous endoscopic gastrostomy (PEG) tube, which delivers feed directly into the stomach. Brian believes the medical team failed to give sufficient consideration to the consequences of withholding nutrition. In its response, Cwm Taf Morgannwg University Health Board defended the decisions made by Marjorie's care team. It said an NG tube had not been considered safe because Marjorie could not sit upright, increasing the risk of aspiration, and because she might pull the tube out. The Board also said the procedure was unlikely to improve her quality of life and that administering fluids could potentially worsen swelling in her brain. It maintained that continuing artificial nutrition and hydration could have caused unnecessary suffering, given the extent of the haemorrhage and the very low likelihood of recovery. Its response explained: "It might be helpful to explain that when someone is sadly nearing the very end of their life, their body naturally slows down and no longer needs food or fluids in the same way. "Continuing to give nutrition or fluids through drips can sometimes cause more harm than good; such as swelling, breathing difficulties, or discomfort - rather than helping." After investigating the complaint, the Health Board concluded that decisions about Marjorie's care had been made collectively in her best interests, with an emphasis on comfort, dignity and symptom control. It said it did not consider that a qualifying liability existed under the relevant NHS regulations. Unhappy with the outcome, Brian escalated the matter to the Public Services Ombudsman for Wales. The Ombudsman upheld parts of his complaint, identifying shortcomings in the hospital's documentation of important treatment decisions, including the decision not to insert an NG feeding tube. The investigation also found that the application to the Court of Protection could have been made sooner. The Ombudsman's adviser acknowledged that there may have been strong medical reasons for not inserting a feeding tube from the outset, particularly as Marjorie's condition deteriorated. However, the failure to properly document decisions about her mental capacity and best interests meant it was impossible to establish the full reasoning retrospectively. The Health Board was instructed to apologise to Marjorie's family for the shortcomings in its record-keeping and review how decisions about artificial nutrition and hydration are documented for patients who have suffered severe strokes and have reduced levels of consciousness. Despite the findings, Brian remains dissatisfied with the outcome and believes the changes do not go far enough to address the concerns raised by his family's experience. He wants policies and procedures changed so that the views of relatives are given greater consideration when important decisions are made about patients who cannot speak for themselves. He said: "I don't feel the Health Board were held to account enough." A spokesperson for Cwm Taf Morgannwg University Health Board said: "We extend our sincere condolences to the family of Marjorie Evans. "The care received by Marjorie was reviewed by the Health Board, and the case was subsequently independently investigated by the Public Services Ombudsman for Wales. "We fully accept the Ombudsman's findings and recommendations and have apologised to the family for the shortcomings identified. We are committed to strengthening documentation standards, reinforcing compliance with the Mental Capacity Act, and improving how treatment decisions, concerns and differences of opinion are properly documented, considered and escalated. "We will ensure that the learning from this case is embedded in practice and will use the findings to improve the experience of patients and their loved ones."