Manchester University NHS Foundation Trust v Y (By his litigation friend, the Official Solicitor)

15 November 2023

[2023] EWCOP 51

Court of Protection

A man with mental health issues needs shoulder surgery but refuses because of his illness. The court decided the surgery is best for him, even though he doesn't want it, and allowed doctors to use restraint if needed to give him the surgery.

Key Facts

•Mr. Y, a 42-year-old with Paranoid Schizophrenia, suffered a fractured and dislocated left shoulder.
•He lacks capacity to consent to surgery due to his psychotic state and delusional beliefs.
•His family supports the surgery.
•The surgery is considered necessary to prevent long-term pain and disability.
•Restraint may be necessary to administer anesthesia.

Legal Principles

Mental Capacity Act 2005 (MCA 2005): Capacity assessment based on understanding, retaining, weighing, and communicating information relevant to the decision.

MCA 2005, sections 2 and 3

Best interests test under MCA 2005: Considers patient's welfare in the widest sense (medical, social, psychological), prospects of success, likely outcome, patient's wishes and feelings, and values.

MCA 2005, section 4; Aintree University Hospitals NHS Foundation Trust v James [2013] UKSC 67

Practice Guidance (Court of Protection: Serious Medical Treatment): Court intervention required for serious interference with rights or restraint exceeding MCA 2005 parameters.

[2020] EWCOP 2

Human Rights Act 1998: Decisions must not violate rights under the European Convention on Human Rights.

Human Rights Act 1998, Schedule 1

Outcomes

Mr. Y lacks capacity to consent to the surgery.

His delusional beliefs prevent him from understanding and weighing the risks and benefits of the procedure.

Surgery is in Mr. Y's best interests.

It prevents long-term pain and disability, aligns with his likely wishes if he had capacity, and respects his value of independence.

Restraint is authorized.

Necessary to ensure safe administration of anesthesia; to be conducted by trained staff, as a last resort, and with respect for Mr. Y's dignity.

Manchester University NHS Foundation Trust v Y (By his litigation friend, the Official Solicitor)

Key Facts

Legal Principles

Outcomes

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