A Local Authority v PG & Ors
[2023] EWCOP 9
Laura Wareham v Betsi Cadwaladar University Health Board & Ors
5 March 2024
[2024] EWCOP 15
Court of Protection
A court decided Laura doesn't have the mental capacity to make decisions about where she lives, her medical care, or who she sees because of her autism. Two doctors disagreed on this, but the judge sided with the doctor who said her autism prevents her from understanding the issues fully. The court is now making decisions for Laura to keep her safe.
Key Facts
- •Laura Wareham (36) diagnosed with Ehlers-Danlos Syndrome and autistic spectrum disorder.
- •Proceedings initiated by Betsi Cadwaladr University Health Board under the Mental Capacity Act 2005 (MCA) concerning Laura's capacity to make decisions about residence, care, treatment, and contact.
- •Contested hearing determined Laura lacks capacity in these areas.
- •Judicial visit conducted after hearing concluded, not before, to explain decision.
- •Significant concerns raised about Laura's parents' interference in her medical treatment.
- •Two expert psychiatrists provided conflicting opinions on Laura's capacity.
- •Court preferred the opinion of Dr. Camden-Smith, who emphasized Laura's autism as the primary cause of her incapacity.
- •Interim best interests orders made regarding social media use and other matters.
Legal Principles
Assessment of capacity begins with the functional test.
A Local Authority v JB [2021] UKSC 52; [2022] AC 1322
Statutory presumption of capacity unless proven otherwise.
MCA s. 1 (2)
All practicable steps must be taken to help P make a decision before concluding incapacity.
MCA s. 1 (3)
Incapacity is not determined solely by unwise decisions.
MCA s. 1 (4)
Court must identify the relevant information for each specific decision in the context of the case.
A Local Authority v JB; North Bristol NHS Trust v R [2023] EWCOP 5
The court's decision on capacity is based on all evidence, weighing expert opinions appropriately.
PH v A Local Authority [2011] EWHC 1704 (COP)
Causative nexus between inability to make a decision and impairment/disturbance of the mind or brain must be established.
A Local Authority v JB
Outcomes
Laura lacks capacity to conduct these proceedings.
Inability to understand the nature of the proceedings, role of the court, and legal representation due to autism.
Laura lacks capacity to decide on residence.
Inability to understand and weigh relevant information, including risks associated with living with her parents, due to autism.
Laura lacks capacity to consent to care and treatment.
Inability to understand and weigh relevant information due to autism, including past medical interventions and the risks posed by her parents' interference.
Laura lacks capacity to consent to deprivation of liberty.
Same rationale as for care and treatment.
Laura lacks capacity to decide on contact with her parents.
Inability to understand and weigh the risks posed by her parents due to autism.
Interim declaration that Laura lacks capacity to use social media.
Reason to believe Laura lacks capacity, pending further assessment.