Anorexia: No forced treatment

Betsi Cadwaladr University Hospital LHB v Miss W [2016] EWCOP 13 concerned a woman aged 28 years who had, for more than 2 years before hearing (and for 10 years of her life in total), been admitted to hospital for treatment of anorexia nervosa. She was continuing to lose weight and it was thought that she would die if that continued.

The court accepted that by reason of her severe anorexia W did not have capacity to make decisions about her treatment of her condition: [26].

The hospital’s application to the court raised two options – feeding under sedation, or discharge into the community with appropriate support.

There was a unanimous professional view that using coercion to get W to eat is no longer appropriate, which the court appears to have accepted: [23]. Accordingly the court approved discharge into the community: [5].

At [52] the court commented on what might happen in the future:

W and her family are understandably anxious that she will not be readmitted to the unit if she deteriorates. As to that, I stress that in approving the order I am only endorsing the Board’s plan in relation to the circumstances as they now exist and for so long as they continue. The court can only make decisions in relation to existing circumstances or circumstances that it can foresee with reasonable confidence. It is accordingly accepted by the Board that if a significant period of time passes, accompanied by signs that W’s thinking and behaviour have been able to change, the normal ethical and legal obligation upon the health services to reassess the situation will exist. In brief, the Board is saying “not now”; it is not saying “not ever”, and it is that outcome that the court is endorsing.

Noted from Ethics & Health Law News.

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