Nottinghamshire Healthcare NHS Trust v RC  EWHC 1136 (COP),  MHLO 20
A 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.
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