RS, Re (Best Interests: Surgery and Intensive Care) [2025] EWCOP 38 (T3)

Best interest decision concerning whether an 18 year old should have surgery to correct curvature of his spine.

RS is an 18 year old with a range of learning difficulties compounded by progressive scoliosis which, if left untreated, could severely reduce his life expectancy as the extreme curvature of his spine would reduce his lung capacity. It was common ground that he lacked capacity and that surgery was the only option to help, however given his learning difficulties, it was felt he would need to be sedated post-op for two to three weeks. The treating clinicians therefore sought an order that this would be lawful.

Mr Justice Poole balances the benefits of the surgery and post-operative treatment plan and agrees it would be in the best interest of RS to proceed with the surgery. At [51] he also notes the Court's role is to some extent to relieve the family and the clinicians of the decision-making burden: 

"The responsibility for this decision is now the Court's. I was told that GH did not want to bear the weight of responsibility herself. She wanted all the clinicians to agree. That has not quite been achieved but she should know that whilst her evidence is of considerable assistance, the decision is not hers and the responsibility for the decision lies with the Court. Likewise, the treating clinicians, including those with doubts about the merits of the decision, can focus on giving RS the best possible care without worrying that they made the wrong call."

Read the judgment on Bailii