A grieving brother who watched his sister slowly deteriorate over 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.
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.
Care decisions and family concerns
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.
Calls for legal changes
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."
Hospital response and Ombudsman findings
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."
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 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.
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."
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."
