Court of Protection  (Hayden J) 17/02/2020

This is a case about an incapacitated person’s best interests in the situation where treatment that was on offer to the incapacitated patient could not easily said to be in her best interests, even though it would keep her alive, given the disadvantages of the treatment for someone in her very much deteriorated condition.

The Court of Protection was presented with a case about an elderly lady, P, suffering from dementia and chronic renal failure. P was supposed to have dialysis three times a week but she was often distressed by the process and sometimes believed it to be a punishment.

There was a meeting in February 2020 between the family and a number of health professionals. It was decided that it was unethical to force dialysis treatment on P when she found it to be unbearable, and that she was to receive the treatment when and only when she was willing to participate. She was often physically exhausted by it.

However, one member of the family objected to the agreement (for reasons unknown) and so the Court of Protection was asked to make a declaration about P’s future treatment.

The decision was held that P was to determine the extent of her dialysis treatment. The treatment was often confusing for her and sometimes called for her restraint. It is thought to be particularly unsuitable for a person suffering dementia.

The court declared that P’s treatment should ideally take into account what she would have wanted for herself. She had been a Catholic and her faith and belief in the sanctity of life were still of importance to her, even through the dementia, so it was decided that she would have wanted to live – and she did accept the treatment sometimes.

The family were seen as having bravely and compassionately navigated through very tricky situations and decisions to arrive at the best possible solution for P – one that was sensitive and kindly. They were commended for their honesty and integrity in dealing with these difficult decisions.

The court granted a declaration to the effect that it would be in her best interests when she seemed willing to accept the treatment but not to force it on her when she did not.

[2020] 2 WLUK 194