An ill 50-year-old grandmother who led a glamorous lifestyle but wants to die because she thinks that she has lost her "sparkle" is mentally capable of deciding to refuse medical treatment, a judge has ruled.
The woman, who has a teenage daughter and adult daughters, had damaged her kidneys when taking an 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 and 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 has dismissed the application, after one adult daughter argued that her mother understood what she was doing and had the mental capacity to make such a "horrible" decision.
The judge made the ruling 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.
He said he was not satisfied hospital bosses had proved that the woman lacked the mental capacity to decide to refuse dialysis.
Mr Justice MacDonald said he would publish his detailed reasons in the near future.
Another judge, who oversaw the case at an earlier stage, has ruled that the woman cannot be identified, but the London-based King's College Hospitals NHS Foundation Trust, which has responsibility for her care and made the application, can be named.
Mr Justice MacDonald described the case as "difficult" and his decision as "finely balanced" - and he said the trust had been right to ask for a ruling.
He was told the woman had faced a number of "problems" before attempting suicide - including failed marriages and financial difficulties.
The judge heard evidence from hospital specialists, from three psychiatrists and one of the woman's adult daughters.
Doctors said the woman's condition would improve with dialysis and other treatment.
Two psychiatrists called as witnesses by the hospital trust argued that the woman lacked the mental capacity to make the decision to refuse dialysis. The third, called as a witness by a legal team representing members of the woman's family, disagreed.
The daughter said 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 her mother's death would be devastating but that she and other family members thought her mother had the mental capacity to decide to refuse treatment and understood the consequences.