Court of Protection Decides on Capacity of Autistic Woman: Legal Principles and Outcomes Discussed

Citation: [2024] EWCOP 15
Judgment on

Introduction

In the Court of Protection case of Laura Wareham v Betsi Cadwaladar University Health Board & Ors [2024] EWCOP 15, the court considered a range of capacity issues pertaining to an adult with various diagnoses, including autism. The case offers a comprehensive application of the Mental Capacity Act 2005 (MCA), particularly sections 1-3, as well as the principles laid down by case law to determine Laura’s capacity to make certain decisions.

Key Facts

Laura Wareham, a 36-year-old woman diagnosed with Ehlers Danlos Syndrome and autistic spectrum disorder, was subject to proceedings concerning her capacity to make decisions about her residence, care and support, contact with others, and her litigation capacity. Following a protracted medical history and concerns raised about her parents’ interference with her medical treatment, various assessments were conducted to understand the extent of Laura’s autonomy.

The case invokes several key legal principles from the MCA and subsequent case law:

  1. Presumption of Capacity: There is a presumption that a person has capacity unless proven otherwise (MCA s. 1 (2)).

  2. Support to Make a Decision: Individuals must be given all practicable help before they can be deemed unable to make a decision (MCA s. 1 (3)).

  3. Making Unwise Decisions: An individual should not be treated as unable to make a decision simply because they make unwise decisions (MCA s. 1 (4)).

  4. Best Interests: Decision-making must be done in the person’s best interests (MCA s. 1 (5)).

  5. Burden of Proof: It is for the party asserting lack of capacity, in this case, Betsi Cadwaladar University Health Board, to prove it on the balance of probabilities (MCA s. 2 (4)).

  6. Decision-Specific Capacity: Capacity is decision specific, meaning the assessment must be made with reference to the specific decision at hand (A Local Authority v JB).

  7. Relevant Information: When determining capacity for a particular decision, one must be able to understand, retain, and use or weigh the relevant information (MCA s. 3).

  8. Causative Nexus: A lack of capacity must be because of an impairment of, or a disturbance in the functioning of, the mind or brain (A Local Authority v JB).

Outcomes

The court made a series of declarations under section 15 of the MCA, stating Laura Wareham lacked the capacity to conduct proceedings, decide on her residence, consent to her care and support regime, and make decisions about contact with her parents. Crucially, the court found Laura’s autism cause of her functional incapacity, satisfying the causative nexus required under the MCA.

In a notably methodical approach, the court refused the application for lack of capacity without proper evidence and made interim orders for Laura’s welfare. These orders included extended authorizations for the deprivation of her liberty, interim supervision of internet and social media use, reflecting the court’s overarching commitment to Laura’s best interests.

Conclusion

In Wareham v Betsi Cadwaladar University Health Board & Ors, the Court of Protection provides a clear illustration of the application of the MCA’s capacity assessment principles. The judgment underscores the necessity of a tailored, evidence-based approach in determining an individual’s capacity to make specific decisions and highlights the court’s critical role in safeguarding the rights and welfare of those who may lack capacity.