Barnet, Enfield and Haringey Mental Health Trust v CC & Ors [2024] EWCOP 65 (T3)

Application by Trust seeking declarations as to whether CC, a 21 year old woman whose life is in danger as a result of anorexia nervosa, had capacity to conduct proceedings, and to make decisions concerning her medication and treatment. 

is a 21 year old woman with anorexia nervosa, autism and a depressive disorder. Her treating clinicians had concluded she could not make decisions about treatment as a result of 'her overwhelming fear and distress' caused by these conditions. Her health was in serious danger because of her malnutrition but CC did not think her anorexia was the problem, rather it was her depression and she believed she had capacity to understand her medical treatment. 

Hayden J at [26] agreed with one of the experts that

"there is a distinction to be made between insight into a decision, and an ability to understand the information surrounding it. The former engenders the decision, the latter is ultimately formulation of the question."

He then goes on to review the differences in the two experts approach to treatment, with one favouring treatment for the ASD as a priority whereas the other suggested use of Esketamine, a drug that could be used to combat the anorexia, and in which CC now invested her hopes, but which had not been tested in any through manner. Hayden J agreed with the ASD first approach as in CC's best interests but without dismissing the future use of Esketamine if appropriate and CC's health was sufficiently robust to give the drug the best chance to succeed. 

Read the judgment on the National Archives