Andy Casey's family refused permission to appeal life support decision

The family of a roofer who will have his life support stopped after a judge ruled he is dead have suffered fresh heartache as an appeal against the decision was lost.

Andy Casey suffered a serious brain injury and fell into a coma after being punched from behind in a pub garden in July. His family had taken his case to court, but failed to persuade the judge to rule against specialists who said he no longer had any brain stem function and is therefore dead.

Mr Casey's sister, Christine, told the judge she did not believe that he was brain-stem dead. But Mr Justice MacDonald ruled doctors can lawfully stop treating the 20-year-old, from Mitcham, southwest London. His family wanted to challenge the ruling but today Lord Justice Peter Jackson and Lady Justice Asplin agreed it was not arguable, as medical evidence “overwhelmingly” suggested he had died.

Dismissing the appeal bid, Lord Justice Jackson said: “The evidence heard by the judge Mr Casey had died was complete, reliable and compelling. It overwhelmingly led to the conclusion he was no longer alive. The declaration of death was the only decision the judge could properly have made. I recognise this outcome is hard for Mr Casey’s devoted friends and family, and I would refuse permission to appeal.”

Hospital trust bosses responsible for Mr Casey's care had asked the judge to rule treatment could lawfully end, but his relatives wanted treatment to continue, saying they had seen movement and signs of life. A lawyer representing St George's University Hospitals NHS Foundation Trust asked the judge to rule it would be lawful to cease artificial ventilation and care.

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Previously, barrister Abid Mahmood told the judge in a written case outline that Mr Casey had been involved in a fight in a pub garden on July 9 and was "punched to the head" and "fell to the ground". He said specialists had diagnosed death on July 16. The judge heard Mr Casey had remained on a ventilator since being injured. Mr Mahmood added the trust had followed the code of practice used to establish a diagnosis of death and conducted successive tests to confirm this.

He said: “The difficulty for family and loved ones is obvious. The loss of brain stem function does not equate with the loss of all neurological activity, such as reflexes which are independent of the brain. Andy does show residual reflex movement… that is common and perhaps even expected.”

In a written ruling, Mr Justice MacDonald said: "Whilst I understand fully the conclusions the family and friends of Mr Casey have, in their sorrow, drawn from his movements and apparent responses to the ventilator, having regard to the totality of the evidence before the court, I am also satisfied what the family are seeing are in fact well-recognised base reflexes that can survive brain stem death."

Mr Casey's sister told the judge she does not believe he is brain-stem dead. She said the judge had looked at video footage showing Mr Casey moving. She previously said: "He reacts to pain. I showed the judge so many videos. How can someone who reacts to pain be dead? We are looking at an appeal."