Key Facts
- •JJ, a quadriplegic prisoner with impaired swallowing, desires to eat boiled sweets, biscuits, and crisps despite a prescribed soft diet (Level 6 diet).
- •Consumption of these foods poses a significant risk of choking and aspiration, potentially leading to death.
- •Spectrum Community Health CIC, providing JJ's care, refuses to provide the non-compliant foods due to safety concerns and potential criminal/regulatory liability for staff if harm occurs.
- •JJ has capacity and understands the risks, but Spectrum declined to provide the sweets even after an Advance Decision to Refuse Treatment was signed.
- •JJ brought judicial review claiming Spectrum's refusal was unlawful, irrational, discriminatory, and breached his common law right of autonomy and Article 8 rights.
- •The judge dismissed the claim, finding Spectrum's policy rational, necessary, and proportionate.
Legal Principles
Medical professionals cannot be compelled to administer treatment they believe is adverse to a patient's clinical needs.
HHJ Sephton KC's decision
Courts should not make declarations that decide issues of criminal liability for future events.
HHJ Sephton KC's decision
Autonomy and self-determination don't entitle a patient to demand treatment not clinically indicated.
Judge's conclusion
A patient can choose between available treatment options but cannot demand treatment a medical professional deems adverse to their needs.
Lord Philips in Burke
Common law suffices for the 'accordance with the law' requirement of Article 8(2) ECHR.
The Sunday Times v the United Kingdom
The determination of reasonable alternative treatments is a matter of professional skill and judgment.
McCulloch & Others v Forth Valley Health Board
Article 8 ECHR: Interference must be 'in accordance with the law' and 'necessary in a democratic society' for a legitimate aim (like protection of health).
Article 8 ECHR
Outcomes
Appeal dismissed.
Spectrum's refusal to provide non-compliant foods was lawful; it was supported by evidence of significant risk to JJ's health and potential criminal/regulatory liability for staff. The court cannot compel medical professionals to provide treatment deemed clinically inappropriate.