Ashworth Hospital Authority, ex parte Ian Brady [2001] 58 BMLR 173 (QBD)

Mental disorder – consent – force-feeding – s63 Mental Health Act 1983 – capacity – incapacity – medical treatment – refusal

Ian Brady, who had been diagnosed as suffering from a psychopathic or personality disorder had gone on hunger strike. The question for the court was whether the hunger strike was a manifestation or symptom of that disorder, such as to trigger s63 Mental Health Act 1983 which allows a patient to be treated for a mental disorder without his or her consent, thus making it lawful to force-feed Brady.

The Court found that, on the balance of probabilities, Brady had been incapacitated in relation to all his decisions in relation to the hunger strike and force-feeding. The judge reasoned that whilst Brady had above average intelligence, as a result of his severe personality disorder he had engaged in a battle of wills and eschewed the weighing of information and balancing of risks, and his decisions in refusing food and force-feedings were incapacitated. In those circumstances the Responsible Medical Offficers were legally empowered to supply medical treatment to Brady in his best interests.

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