North East London NHS Foundation Trust v Beatrice [2023] EWCOP 17

Judgment concerning capacity to make decisions about nutrition where 'Beatrice' has capacity in all other respects

Beatrice (as she is anonymised in the judgment) was described as a highly intelligent 50 year old but one who had suffered from anorexia nervosa since she was 14 years old. She had now decided she could no longer fight the illness: as Mostyn J describes it a "figurative terrorist invaded and took occupation of part of her mind 36 years ago". At the time of the application Beatrice was refusing nutrition wishing to go to a hospice to die, but equivocated and resumed small quantities of nutrition so the trust sought free standing declarations that she lacked capacity to decide on her nutrition and hydration and to litigate the application.

After reviewing the evidence and authorities, Mostyn J concludes that she does lack capacity, largely because of the nature of the condition [34]: 

"the evidence showed beyond any doubt at all that the key weighing component within Beatrice’s decision-making process was not merely rendered faulty by the condition but rather that the condition caused it entirely to disappear. "

He then goes to grant the second declaration as a matter of logic: as Beatrice is robbed of the ability to weigh information about her illness then "she will be  equivalently disabled from formulating and making submissions to a judge as to how he or she should undertake that very weighing exercise" [36]

Read the full judgment on Bailii