Court declines to order surgery

Posted: 12th October 2015

RCJMentally ill people are often viewed as having limited capacity to make important decisions for themselves but the High Court’s refusal to sanction a life-saving operation against the wishes of an elderly schizophrenia sufferer has underlined that they are still entitled to have their views and opinions respected.

The man, aged 73, had a long history of mental illness and lived an isolated life with no family to support him. He had developed a severely infected left leg and doctors were unanimous that his foot had to be amputated or he would swiftly die. However, the fiercely independent pensioner was adamant that he did not want to have the operation and that nature should be left to take its course.

Treating doctors asked the Court to authorise performance of the operation without the man’s consent. The Court acknowledged that he lacked mental capacity in the legal sense and that his imminent death was avoidable. He did not understand the reality of his condition, mistrusted doctors and believed that he would recover. He had stated that God had told him not to have the operation and that angels had reassured him that he would be going to heaven.

Nevertheless, in refusing to authorise the operation, the Court underlined that the beliefs and values of people lacking capacity should not be routinely undervalued. The man’s deeply held religious beliefs did not deserve to be described as delusional and his fortitude in the face of death would be the envy of many people in better mental health.

Doctors were agreed that the operation would probably only give the man a few more years of life and that a fully rational person might choose not to undergo it. Given his views on life and death, he was very unlikely to change his mind and it was not in his best interests to take away what little independence and dignity he had to replace it with a future for which he understandably had little appetite.