Lancashire & South Cumbria NHS Foundation Trust & Lancashire County Council & AH [2023] EWCOP 1

Best interests decision concerning AH, a female who may die if she mismanages her diabetes but who wants to return home from her current placement where she is unhappy

AH has been the subject of a previous judgment: [2022] EWCOP 45 and the background to these proceedings is set out there. In this judgment, HHJ Burrows has to determine AH’s best interests , deciding whether she should stay in her current placement, which AH dislikes but where her medication is properly administered, or be allowed to return home with medication provided by district nurses. The current arrangement, approved by the judge earlier in proceedings, was that AH would remain in the placement but be allowed out during the day and stay at her home one night a week. 

In the light of various funding and logistical challenges, that hybrid approach was unsustainable so the options available to the judge was either a full time placement at the home (and in which case AH would lose her flat) or to allow AH to go home despite the risks. He reviews various cases and cites in particular Re M (Best Interests: Deprivation of Liberty) [2013] EWHC 3456 (COP) where Peter Jackson J comments:

"The right to life and the state’s obligation to protect it is not absolute and the court must surely have regard to the person’s own assessment of her quality of life"

In HHJ Burrows eyes, this is the nub of the matter in this case so, in that light and despite the risks, at [65] he concludes that AH has

“the right to her liberty and to remove it from her would be a devastating blow to her and would not properly recognise her right as a disabled person to be afforded respect and dignity for the way she wishes to live her life.“

Read the judgment on the National Archives