Person-Centred Decision Making in the Court of Protection

By Sara Shorten – 22nd June, 2020

Last week I had the opportunity to attend a Court of Protection remote hearing before the honourable Mr Justice Hayden (listed as case number 13596518 Re ‘D’ in the Royal Courts of Justice list on 19 June 2020).  

It was the first COP hearing I had been to and due to COVID-19, it was being held online via Microsoft Teams. This enabled me to request access to the hearing and join it with ease.

The hearing related to a young woman with a cognitive impairment, a complex mental health background and a number of vulnerabilities.  The court was considering issues relating to where she should live, medical decisions (including contraception), and concerns relating to her capacity to engage with public health messages and social distancing during the pandemic.

The first thing that struck me was the rigid formality when addressing the judge.  Was I going to understand what was happening?  

Then what came next was the most surprising – but obvious and appropriate – request by the Judge: “Is D joining us? It would be lovely to meet her and talk directly to her.”

As a nurse my main focus is that the person remains at the centre of everything.   It was so reassuring to see that this also was the primary focus within a formal court hearing for Mr Justice Hayden.  The person-centred approach to this hearing epitomises and reflects exactly what I believe the Mental Capacity Act is all about.  Mr Justice Hayden reinforced this focus on the person at the centre of the case throughout the hearing – especially when the lawyers were drifting away from being decision- or time-specific.

I felt very reassured that person-centred decision making triumphed in this case.

As stated by Mr Justice Hayden “This is not a paternalistic Act. It is an autonomous Act”.  My role within my organisation enables me to echo those words.

For me, patient autonomy is a fundamental principle within healthcare and the MCA requires us to appreciate the importance of the principle of autonomy and individualised decision-making in everything we do, with every person we care for.

I will be aiming to attend many more of the court hearings and hope to give feedback information about how the court works and the way it makes decisions, both through this blog and to my organisation.

Sara Shorten is the Mental Capacity Act Lead and Matron at Norfolk and Norwich University NHS Trust.  She is an RGN and has been nursing for 29 years.  She tweets @ipswichgrove.