Wye Valley NHS Trust v B
In deciding what is in the best interests of a person who lacks capacity, the person's wishes and feelings may be decisive, so a man could not be forced to have his leg amputated against his strong wishes.
Facts
Mr B, a 73 year old man with a long history of mental illness, had a seriously infected leg, and the doctors considered that he would probably die unless his leg was amputated. He strongly refused the operation, saying that he did not want it and was not afraid of dying. The hospital accepted that he lacked capacity to make the decision, because his mental illness affected his understanding, and applied to the Court of Protection for a declaration that the amputation would be in his best interests.
Legal principle
Peter Jackson J refused the declaration. He said that the Mental Capacity Act 2005 requires the court to consider the person's wishes, feelings, beliefs and values in deciding what is in his best interests, and that a conclusion that a person lacks capacity does not mean that his wishes count for nothing. Where the person's wishes are clear and firmly held, and based on his own values, they should carry great weight, and may be decisive. It would be wrong to force Mr B to undergo an operation he did not want, given the burdens of the operation and its aftermath, and his clear and long held views.
Related cases on consent, capacity and refusal of treatment
- Re B (Adult: Refusal of Medical Treatment) [2002] EWHC 429 (Fam)
- Re C (Adult: Refusal of Treatment) [1994] 1 WLR 290
- F v West Berkshire Health Authority (Re F (Mental Patient: Sterilisation)) [1990] 2 AC 1
- Re MB (Medical Treatment) [1997] 2 FLR 426
- P v Cheshire West and Chester Council [2014] UKSC 19, [2014] AC 896
- R v Bournewood Community and Mental Health NHS Trust, ex p L [1999] 1 AC 458
- St George's Healthcare NHS Trust v S [1999] Fam 26
- Re T (Adult: Refusal of Treatment) [1993] Fam 95
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