Capacity decision relating to ST a young woman dying with a progressive disease who wishes medical treatment to continue in order to seek treatment abroad.
ST is 19 and has an extremely rare mitochondrial disorder which causes a progressively degenerative disease for which there is no cure. She was admitted to hospital in August 2022 and treatment has become steadily more invasive and extreme. The treating clinicians say she is actively dying and wish to start palliative care. However ST wishes to 'die trying to live' and is seeking continued medical treatment to prolong her life and be able to travel to the US where she may be accepted to take part in clinical trials which ST hopes will cure her.
Roberts J makes clear this judgment is strictly limited to ST's capacity to make decisions about her medical treatment and to litigate, not to consider her best interests. She provides a thorough review of the medical evidence of the clinicians and experts appointed to assess ST's capacity, who came to differing conclusions. A key issue was how to account for ST's belief that should be cured and her views on what palliative care entailed. At  she asks herself
'The question which I must answer in the light of this evidence is whether ST is thereby rendered unable to make a decision in relation to her medical care because of an impairment of, or disturbance in the functioning of, her mind or brain.'
She is satisfied it is the case here because, broadly, of the trauma suffered by ST by admission to, and long stay in hospital, and her fear of dying. Given the decision ST lacked capacity to decide on her medical treatment, it followed she also lacked litigation capacity.
Read the judgment on the National Archive.
Case summaries on every Court of Protection case & other relevant decisions with links to the full judgment where available.
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