Nottingham University Hospitals NHS Trust & Anor v RL & Ors [2023] EWCOP 22

Capacity and best interests judgment concerning RL who has been refusing food in prison.

RL had been jailed for life and in 2021 concerns grew about his welfare as he started to refuse food, then stopped communicating verbally. In January 2023 he was admitted to hospital with very low body weight. As one treating doctor put it, although he will not die within the hour, the longer treatment is delayed, the more dangerous the situation in the immediate and long term. The Trust applied for authorisation to administer nasogastric feeding, and to treat his mental health and thyroid conditions.

In this judgment Cohen J first considers capacity. He accepts evidence that it is impossible to know RL's wishes because he will not express them himself. In addition, before the hearing the team had inserted a nasogastric tube which RL had not resisted. He therefore declares RL lacks capacity in this respect under s15 and then goes on to consider his best interests. He notes that RL's mother is  clear that her son’s current presentation is out of character and believed he would want treatment. Given this he states there is a strong presumption in favour of treatment being administered but to be reviewed by the court in the very near future. 

Read the full judgment on Bailii