Cases Flashcards
C (capacity)
Re C - schizophrenic patient with a foot infection, claims to be a doctor and that he knows how to treat it by himself. (Do not make judgments on unwise decisions- unwise choice does not equal to lack of capacity, he did understand the matter, seriousness and consequences)
He also believed (apparently many do) that if you cut your leg or lose any other parts of your body you will not be let into heaven.
Mb (capacity)
Re Mb- pregnant woman with needle phobia. First said that they should treat her with needles even if she resists when she gives birth but the closer to the date of the birth she became more anxious and less “there”. Mental capacity can fluctuate one day you can have full capacity and other you do not.
B (capacity)
Re B- woman with a serious illness on a life support with a history of depression. Asks to withdraw from her previous decision and to stop the life support, court questioned whether her capacity has been affected and if it’s depression or her real decision- it was her true decision.
HL (capacity)
(HL has people taking care of him 24h , one day they couldn’t be there, he panicked and social worker moved him to a hospital because he did not resist)
L has autism and learning disabilities, which prevent him from having capacity to consent the decision relating care and treatment. There is people who provide him with 24-h care.
One day L becomes very distressed while attending his day centre. The people who take care of him were not there to calm him down. So a social worker arranged for admission to a hospital for assessment. He showed no sign of resistance towards admission.
Mha prevents the use of compulsory detention for assessment if patient makes no active refusal.
His psychiatrist prevented him from going home in the basis of his best interest to receive hospital treatment until he was suitable for discharge.
Later court of appeal decided that he was detained unlawfully and awarded damages.
L submitted: that his time in hospital as an informal patient amounted to deprivation of liberty 5(1) human rights. The detention was not in accordance to procedures.
To which they said: his hospital care did not remove the possibility of deprivation of liberty especially in the light of his mental capacity. And continuous supervision and control from the staff represented such deprivation.
And they agreed that the procedures available to him as informal patient for the review of the legality of his detention did not comply with the 5(4) human rights.
Bournewood (capacity)
( unlawful to admit autistic adult to a hospital even if he did not object)
1977 decided that it was unlawful to admit autistic adult to a psychiatric hospital on an informal basis that the patient lacked capacity even if he did not object.
“The bournewood gap” is being closed by amendment to mental capacity act 2005.
When someone lacks mental capacity to consent or treatment they fall into two groups:
- Lack of compliance show that they do not want to do whats being offered. (Clear refusal)
- Those who make no comments and just comply with whatever confusion whether they understand or not . (If there is no refusal you can’t section them, necessity of best interest takes over)
Managers of edgware ( nearest relative case)
( called father in a rushed way)
Detaining a patient under s 3 of mha was unlawful as the consultation with his nearest relative was not meaningful.
S.26 says that persons nearest relative is normally the person closest to the top of their list husband, wife civil partner, son daughter, father mother, brother sister etc.
The issue with this case as lord Burnett said: “they set a motion a course of events which was designed to leave consultation with his father to very last moment, thus inhabiting the chance of him having any effective input into the process” his chances to make any objections were taken away.
Enfield Borough Council (nearest relative)
Approved social worker was considering whether it was “reasonable “ to consult the nearest relative before admitting a patient.
(Think of it as an urgent treatment and calling nr as a delay to it)
Cygnet( nearest relative)
(Cygnet nearest relative was consulted via telephone, they did not speak or understand english. Was that the best that the law can do?)
was admitted to hospital on the basis os schizophrenia on several occasions.
Legally application under s3 cannot be made if nr objects, would cause unreasonable delay or until the patient’s nearest relative under s.5 s11(4) has been consulted.
Was this the best option for them?
Bulgaria (deprivation of liberty) (procedural)
(suffered from schizophrenia and was unable to take care of himself, his guardian decided to put him in a care home without his knowledge.)
Stanley alleged violation of art 5 (1) right to liberty and security. He was involuntarily detained in a psychiatric hospital in Bulgaria, he claimed that his detention was unlawful.
court found out that there was no legal basis for his detention and that it was not justified by medical necessity.
This case shows the need for legal safeguards and procedural requirements when it comes to involuntary detention.
Neary (deprivation of liberty)
(this case led to increased awareness of the rights of individuals with autism and intellectual disabilities.)
Young man with autism, was deprived of his liberty when was placed in a care facility. His father challenged this decision.
This case questioned rights of the individuals with autism and the authority of local councils to make decisions regarding their care and placement.
Court ultimately ruled in favour of nearly, this case led to increased awareness of the rights of individuals with autism and intellectual disabilities.
Havering (depravation of liberty)
(A had several learning disabilities and autism, he was taken care by her mother until she became too ill to continue then got moved to a care home family disagreed. Court agreed for deprivation of liberty)
Court examined the issue of deprecations of liberty safeguards (dols) under mental capacity act 2005.
A got moved to a care home, but A’s family disagreed with this decision, and said that it amounts to depravation of liberty and that the correct procedures were not followed.
court agreed.)
Worcestershire’s
(if Worcestershire moved to a different place and got re sectioned ,that place would be responsible for him and all the costs (S. 117 aftercare leaving hospital), there should be a new amendment to new bill but instead they issued a whole new guidance.)
Birch
(A woman pleaded guilty to manslaughter by diminished responsibility, she married a younger man who cheated on her making her intensely jealous, her mental condition worsened: she became depressed, increased drinking and argued with her husband frequently. at some point she got a gun and lured him into some apartment and locked the door, shot him from 3 feet distance, then stabbed him 5 times one wound was 9-10 cm deep. He died shortly afterwards. Her mental state seemed to change from each interview but ultimately it was decided that it’s very unlikely for this to happen again)
A woman pleaded guilty to manslaughter by diminished responsibility, she married a younger man who cheated on her making her intensely jealous, her mental condition worsened: she became depressed, increased drinking and argued with her husband frequently. One time she hit him on the head with a bottle, at some point she got a gun and lured him into some apartment with a friend and locked the door, shot him from 3 feet distance, then stabbed him 5 times one wound was 9-10 cm deep. He died shortly afterwards.
Court recommended mental health act 1983 s37.
Her mental state seemed to change from each interview, one time she was seen as a threat to the society other times she was suicidal and a threat to herself, ultimately it was decided that if she did not end up in the same circumstances she is not dangerous and a repetition of the event is unlikely.
Smirek v williams
(Smirek shows injustice of mental health law, overriding interest of the views of nearest relative but also how difficult it is for nearest relative to avoid being found unreasonable if they disagree with the hospital.)
This case illustrates several aspects of the mha law and it’s injustice, it shows the overriding of the views of nearest relative ,and how difficult it is for nearest relative to avoid being found unreasonable if their views differ from the hospital.
munjaz (procedural)
Munjaz believed that he was detained unlawfully because the hospital’s decision to detain him miss-understood the law.
