Manchester University NHS Foundation Trust v WV [2022] EWCOP 9

Decision about whether William, a 17 year old who lacks capacity due to autism and ADHD, should have a kidney transplant,

William has diagnoses of moderate to severe learning disabilities with autistic spectrum condition and ADHD, with accompanying behavioural disturbances. He has hypersensitivity to anything on his skin and it is not unusual for him to pick at dressings protecting lines or tubes going into his body. In 2019 he was diagnosed with Steroid Resistant Nephrotic Syndrome and began kidney dialysis, though sometimes he put up a struggle. He is reliant on venous access but that will only be possible for another 12 months as he is running out of veins that can be used so the only treatment is a transplant.. 

The Trust originally argued that it was not in William’s best interests to have the transplant however Arbuthnot J, after a thorough review of the evidence presented to her and consideration of the various outcomes possible, concludes the opposite. Though there is the risk of significant psychological harm to William as a result of the surgery and subsequent sedation it is a case of what [157]

“is the least bad decision for William. I must put myself in his shoes to decide what he would want. He does not understand the risks to him of a transplant and he is frightened about what it will entail but I have no doubt that he wants to have a life without HD. The only possibility of him having a longer life with an even better quality is through having a transplant.”     

Read the judgment on Bailii