Refusing Consent For Surgery

TC was 69 when she presented with a supraglottic laryngeal cancer, affecting both her breathing and swallowing.

An eagerly awaited case has been decided. You may recall the story of ABC, whose father, XX, killed her mother, leading to his detention in a psychiatric facility.

Two recent cases with similar facts have resulted in different outcomes. ZA was a 53 year old schizophrenic woman who lacked capacity, and would die if she did not undergo an above knee amputation.

The therapeutic relationship is based on a patient's trust and confidence; in particular that she believes that her doctor (or any other clinician) knows what they are doing.

In August 2019, a hospital sought a court declaration that RR (a 20 year old man)lacked the capacity to make decisions about the palliative care that he was being offered, and to approve the proposed plan.

It is intuitive that delusional illness impairs patients' capacity. But equally we are now well aware of the danger of discriminating against people on the basis of irrelevant considerations, as embodied in the Equality Act 2010.

It is not unusual to hear that a child or young person is refusing treatment, and that those with parental responsibility are providing consent on his or her behalf. Whether parental consent is valid in these circumstances requires resolution in each case. Highly unusual is a different presentation: where a competent child is seeking treatment and providing valid consent, but the parents oppose the intervention.

P is 17 with severe autism, living with his parents. He is unable to communicate in any consistently effective way.

Courts in England pass no judgement on but give considerable weight to families' religious beliefs provided they are legally and socially acceptable. The child's interests remain, however, paramount in all aspects of their upbringing, including religious matters.

It is not uncommon to receive a request from the police for patient data. Recently we admitted a patient who had suffered an injury at home, and it was thought not to have been an accident.