GUP v EUP & Anor
[2024] EWCOP 3
North East London NHS Foundation Trust v Beatrice (No 2)
18 May 2023
[2023] EWCOP 60
Court of Protection
A woman is very sick and doesn't want to be force-fed. Even though doctors want to help her, the judge said it's more important to respect her wishes, because forcing her would cause more harm than good. The judge's decision was based on the law that prioritizes people's choices about their own bodies, even if they're ill.
Key Facts
- •Beatrice, lacking mental capacity, suffers from an eating disorder.
- •Further treatment to achieve weight gain is considered futile and overly burdensome.
- •Beatrice strongly opposes forced feeding.
- •Clinicians would not be prepared to implement forced feeding even if ordered.
- •Beatrice's family members hold differing views on treatment.
Legal Principles
Presumption in favour of prolonging life (Article 2 ECHR, Human Rights Act 1998, s.4(5) Mental Capacity Act 2005)
European Convention on Human Rights, Human Rights Act 1998, Mental Capacity Act 2005
Consideration of the person's wishes and feelings (s.4(6) Mental Capacity Act 2005)
Mental Capacity Act 2005
Consideration of family views (s.4(7) Mental Capacity Act 2005)
Mental Capacity Act 2005
Best interests assessment must consider medical, social and psychological welfare (Aintree University Hospitals NHS Foundation Trust v James)
Aintree University Hospitals NHS Foundation Trust v James [2013] UKSC 67
Presumption in favour of life preservation can yield to respect for autonomy and dignity (Aintree University Hospitals NHS Foundation Trust v James)
Aintree University Hospitals NHS Foundation Trust v James [2013] UKSC 67
Respect for individual autonomy (Article 8 ECHR, common law)
European Convention on Human Rights, common law
Outcomes
Only treatment involving feeding and/or weight restoration clinically indicated and expressly accepted/requested by Beatrice is permitted.
Respect for Beatrice's strong wish to not be forcibly fed outweighs other factors. Forced feeding is deemed futile, overly burdensome, and likely to be resisted.
Declaration that it is lawful for clinicians not to forcibly provide nutrition and hydration against Beatrice's wishes.
Protects Beatrice's autonomy while acknowledging that treatment can be provided if she requests it.
Declaration that it is lawful for clinicians to refer Beatrice for end-of-life care, but not to force her to go.
Supports the decision to respect Beatrice's wishes while providing options.
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