When another assessment is not needed: Best interests decision-making for a patient with a prolonged disorder of consciousness

s going to be, what would he have decided? He was not going to decide that on the basis of a SMART score.”

What happens when Lasting Power of Attorney goes wrong?

“There had been a major family falling out between the LPA and her siblings. They saw her as “controlling”, “aggressive” and “paranoid” and said she had imposed unnecessary restrictions on their right to see their mother.” The judge said, ““I appreciate there’s a family dynamic, and it’s tragic to see it play out”. 

A court-authorised hip replacement

declaration ordering surgery was the right outcome. I saw a rigorous but caring and collegial environment in court, with a genuine commitment to involving P. Counsel for the parties adopted a clearly non-adversarial approach throughout. The focus for everyone was on making the right decision for P.

Home-owning resident of 50 years faces intervention by Council

By Daniel Cloake, 24th September 2021 A man whose identity is protected by court order faces temporary removal from his home of 50 years to enable building work and medical treatment to be carried out. I observed this attended (in-person) hearing (Case: 12014791 “JD -v- Ealing Council”) before the Senior Judge of the Court of Protection HHJContinue reading “Home-owning resident of 50 years faces intervention by Council”

Challenge to Lasting Powers of Attorney

By Claire Martin, 23rd September 2021 I observed a remote hearing (COP 13339015) at Lincoln Family Court on 6th September 2021. District Judge McIlwaine was presiding.  The case concerned a challenge to Lasting Powers of Attorney from the Office of the Public Guardian and was preparatory to a final 3-day hearing starting on 27th September 2021.  The applicant is P’s daughter,Continue reading “Challenge to Lasting Powers of Attorney”

Refusing blood products during pregnancy and labour

“The Official Solicitor observes that P is considered capacitous in all the areas in which she is willing to take that [medical] advice; it is only where she is not willing to follow medical advice that she is considered to lack capacity”. 

Forced HIV treatment? A censored account of a case involving possible restraint

By Celia Kitzinger, 9th September 2021 UPDATE: After I corresponded with counsel in this case, the Transparency Order was varied. The original transparency order that was sent to me prohibited publication of any material or info that could identify P including her age, ethnicity/national origin, and the identity of the clinicians or any other witnesses in the case.Continue reading “Forced HIV treatment? A censored account of a case involving possible restraint”

Risk-averse medical decisions, the right to privacy, and best interests: Video-monitoring Part 3

If a best interests’ process had been followed and it had been decided that monitoring was not in David’s best interests, then no court hearing would have been needed and P would not have had his Article 8 right violated for a long time.  If there had been disagreement (e.g. between parent and clinician) after a best interests process, then an application to the Court of Protection might have led to a case process similar to this, but without delay.  The issue in this case is that there was no best interests’ process at all!

Best interests in a contested end-of-life case: Cambridge University Hospitals NHS Foundation Trust v AH & Ors [2021] EWCOP 51

What Claire and I witnessed in the Court of Protection was a determined, serious, and lengthy attempt on the part of the judge to determine what AH would want, in the absence of any direct record to help him.  Mr Justice Hayden tried very hard to find out what her wishes would be, and to respect them – giving effect to her autonomy and self-determination.

Secure units and young people: In search of home to call your own

Admission to a restrictive hospital environment does not resolve the underlying reasons as to why young people self-harm and may paradoxically increase risk by encouraging young people to move to new and often more lethal ways of harming themselves once access to their usual means is removed.