Can a patient who lacks capacity refuse medical treatment? Wye Valley NHS Trust v B


Mr B, aged 73, has Type II diabetes and a severely infected leg caused by chronic ulceration; and unless doctors amputate his foot he will die, possibly within a few days, because his wound has passed the stage where removal of infected tissue is an effective treatment. If he has the operation, however, he may live for a few years more. He also has paranoid schizophrenia, which deprives him of the capacity to make the decision for himself. For a long time, Mr B has experienced persistent auditory hallucinations in which he hears voices of angels and of the Virgin Mary. He told the judge that he did not consider himself to belong to any particular religion, saying I’m not fussy, but explained that Mary wanted him to be a Roman Catholic [19].

In May 2015 Mr B was detained compulsorily under s 3 of the Mental Health Act; nevertheless, he continued to resist medication for his diabetes and antibiotics for his foot, with the consequence that by the time his mental health had begun to recover in August, his physical health had markedly deteriorated [23]. A best interests meeting in September concluded that an application should be made to the Court of Protection and the matter first came before the court on 18 September, when the present hearing was fixed, reported as in Wye Valley NHS Trust v B [2015] EWCOP 60. On 25 September the judge, Peter Jackson J, met Mr B in his hospital room for over an hour in the presence of his clerk, who took a note, and a nurse, Mr F, who helped the judge understand everything that Mr B wanted to say [26]. Continue reading