B v Ashworth Hospital Authority [2003] EWCA Civ 547

Mental health – treatment – consent – s63 MHA 1983

The Court of Appeal overturned the decision of the High Court (see below) which had ruled that s63 MHA 1983 sanctioned the treatment of a detained patient for any mental disorder which had been diagnosed by clinicians.

The Court held that where a court had made a hospital order in respect of a patient classified as suffering from mental illness, the compulsory treatment of the patient under s63 for personality disorder was unlawful. The Mental Health Act was concerned with mental disorders which were treatable and which justified detention for their treatment. The Court added that the Act provided a detailed and carefully worked out scheme for the admission of mentally disordered patients to hospital for treatment.  The natural interpretation of s63 in its statutory context was that treatment, other than treatment falling within sections 57 and 58, might be given without the patient’s consent, but only for classified mental disorders.  Unless and until B was reclassified by the Mental Health Tribunal as suffering also from a psychopathic disorder, it would not be lawful to continue his treatment for that condition.

 

B v Ashworth Hospital Authority [2002] EWHC 1442 (Admin)

Mental health – treatment – consent – s63 MHA 1983B had been detained in hospital pursuant to an order under sections 37 and 41 MHA 1983, following his conviction for the manslaughter of his girlfriend. He sought judicial review of the hospital’s decision to place him on a ward for those suffering from a personality disorder despite the fact that he had been classified by the Mental Health Review Tribunal as suffering from a mental illness. B argued that the hospital was acting unlawfully by providing treatment for a personality disorder without his consent and locating him on a ward for personality disorders when the MHRT had classified him as suffering from a mental illness; and that ‘the mental disorder’ in s63 of the Act meant that it was therefore mental illness, as ‘diagnosed’ by the tribunal and no other illness for which he should be treated. S63 states: ‘the consent of a patient shall not be required for any medical treatment given to him for the mental disorder from which he is suffering, not being treatment falling within section 57 or 58 above, if the treatment is given by or under the direction of the responsible medical officer’.

The Court rejected B’s arguments: the words ‘the mental disorder’ in the Mental Health Act 1983 s63 meant the patient’s actual disorder as diagnosed by the clinicians, which was not necessarily the formal classification of the MHRT. Further, it was possible to receive a dual classification of both mental illness and psychopathic disorder. If Parliament had intended that the classification made by the Tribunal was final, it would have said so. It was a matter of professional judgment for doctors to administer the best treatment for the disorder from which a patient was suffering.

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