Northamptonshire Healthcare NHS Foundation Trust V AB [2020] EWCOP 40—Mental Capacity and the Anorexic Patient in the Court of Protection: Understanding Values, Framing Matters and Specification of the Declaration
Authors: Watkins, M.
Journal: Medical Law Review
Publisher: Oxford University Press
ISSN: 0967-0742
DOI: 10.1093/medlaw/fwac002
Abstract:Northampton Healthcare NHS Foundation Trust v AB1 adds to the long line of cases dealing with capacity and the assessment of best interests for those who suffer from eating disorders, particularly anorexia nervosa.2 AB was challenged on her ability to make decisions about life-sustaining treatment through (potentially forced) tube feeding, and palliative care. Roberts J found that whilst AB was ‘intelligent, articulate and demonstrate[d] clear insight into some aspects of her illness’, anorexia had undermined her ability to appropriately weigh and balance information in connection with ‘food, calorific intake and consequent weight gain’ and therefore she lacked capacity to make decisions about her treatment.3
The case, whilst not factually novel, offers an opportunity to shine light onto the ongoing conceptual confusion about how to assess the functional ability of those with eating disorders, particularly, in relation to an individual’s ability to understand and weigh information under section 3(1)(a) and (c) of the Mental Capacity Act 2005 (‘MCA’).4 As well as, the problematic construction of declarations; which frame capacity questions in such a wide-way as to exclude individuals from decisions relating to their treatment and care, where they may potentially have capacity.
Source: Manual
