Category

Advance decision cases

Case and summary Date added Categories
Nottinghamshire Healthcare NHS Trust v RC [2014] EWHC 1317 (COP), [2014] MHLO 22A detained patient (RC) was self-harming by cutting and had made an advance decision refusing blood transfusions. (1) RC had capacity to refuse blood transfusions and sometimes had capacity to lacerate himself. (2) The advance decision was valid and applicable. (3) The self-harming was a symptom or manifestation of mental disorder so a blood transfusion would be treatment under s63 MHA 1983. (4) Where the consequences of a decision not to impose s63 treatment may be life-threatening the Trust should apply to the High Court for declaratory relief and (just as with a decision to impose treatment) the hearing will involve a 'full merits review'. (5) It would be lawful to withhold blood transfusions despite the s63 power (indeed, the judge stated that given RC's current capacity and advance decision it would be 'an abuse of power ... even to think about imposing a blood transfusion' and that it 'would be a denial of a most basic freedom'). 2014‑05‑02 00:58:58 2014 cases, Advance decision cases, Brief summary, Transcript


Nottinghamshire Healthcare NHS Trust v RC [2014] EWHC 1136 (COP), [2014] MHLO 20A detained patient with a severe personality disorder was self-harming by cutting and had to be mechanically restrained to prevent this. (1) He had made an advance decision, apparently with capacity to do so, refusing blood transfusions because of his religious beliefs: the court ruled that this was valid and applicable, but only on an interim basis since the document did not state that it was signed by the maker and the witness in each other's presence. (2) The Responsible Clinician accepted that a blood transfusion would be medical treatment for mental disorder under s63 MHA 1983, and therefore the advance decision could be overridden; however, because the patient's wishes were religious, she did not want to impose treatment: the Trust therefore sought the protection of a court declaration that her decision was lawful. (3) The court was unwilling to make the declaration, without hearing both sides of the argument, because of the importance of the issues (including the right to life under Article 2, freedom of religion under Article 9, and respect for private life, which includes bodily integrity, under Article 8). (4) The Official Solicitor was invited to attend a hearing the following day, the Trust was asked to facilitate the patient being directly represented and to encourage the father to attend, and the judge concluded that if there is an argument for the use of s63 it was very important for the court to hear it. 2014‑04‑27 21:20:43 2014 cases, Advance decision cases, Brief summary, Transcript


X Primary Care Trust v XB [2012] EWHC 1390 (Fam), [2012] MHLO 54 — "This matter concerns an application by the XPCT for declarations under s.26(4) of the Mental Capacity Act 2005 as to the validity of an advance decision made by XB on 2nd November 2011 that he wished, amongst other things, to have his ventilation removed in certain defined circumstances." [Summary required.] 2012‑06‑21 20:56:06 2012 cases, Advance decision cases, No summary, Transcript


Re D; An NHS Trust v D [2012] EWHC 885 (COP), [2012] MHLO 47(1) P was in a permanent vegetative state so continued medical treatment is of no benefit to him because it is futile. (2) His letter refusing life-sustaining treatment did not comply with the MCA requirements for an advance decision so could not have been relied upon; however, had the evidence on PVS not been clear cut, the judge would have given P's previous wishes and feelings great weight. 2012‑05‑05 13:11:22 2012 cases, Advance decision cases, Best interests, Brief summary, Transcript