X NHS Foundation Trust v RH
[2024] EWCOP 150
TTN (Medical Treatment: Retinal Detachment), Re
17 January 2024
[2024] EWCOP 1
Court of Protection
A man with mental health issues needs eye surgery but doesn't understand it because of his illness. The court decided the surgery is best for him even though he doesn't want it, and it's okay to use medicine to help him have the surgery.
Key Facts
- •TTN, a 73-year-old man with schizo-affective disorder, is hospitalized under Section 3 of the Mental Health Act 1983.
- •TTN suffers from a detached retina in his right eye, threatening complete blindness.
- •TTN lacks capacity to decide on the proposed vitrectomy due to delusional beliefs.
- •The Official Solicitor acts as TTN's litigation friend.
- •The application seeks court authorization for the vitrectomy and use of sedation/restraint if necessary.
Legal Principles
Mental Capacity Act 2005 principles: presumption of capacity, best interests, all practicable steps, unwise decisions, definition of incapacity.
Mental Capacity Act 2005
Best interests decision-making under the Mental Capacity Act 2005.
Mental Capacity Act 2005
Serious Medical Treatment Guidance [2020] EWCOP 2.
[2020] EWCOP 2
Outcomes
TTN lacks capacity to decide on medical treatment.
His delusional beliefs prevent him from understanding and weighing relevant information.
Vitrectomy is lawful and in TTN's best interests.
The potential benefit of preserving some vision outweighs the risks, considering the poor prognosis without surgery.
Sedation and restraint are lawful and in TTN's best interests if necessary.
Necessary to facilitate the safe performance of surgery, least restrictive option.
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