St George's University Hospitals Foundation Trust & Anor v LV [2025] EWCOP 9 (T3)

Best interests decision regarding medical treatment for LV, who has a life-threatening eating disorder but is refusing treatment.

LV is 20 years old and has been detained in hospital for two years under s3 of the MHA. The issues in this application arise from her anorexia: she is refusing to eat and even when force fed has developed techniques that allow her to regurgitate food during the process such that her BMI is now 11. However she also displays behaviour, such as making friendship bracelets, that exhibit a desire to live. The Trust in this application were seeking declarations that LV lacked capacity to make decisions about her treatment and that she should be admitted to an in intensive care unit for a period of feeding under sedation, as the medics agreed this was the only option available.
After summarising the relevant law, Mrs Justice Morgan agrees LV lacks capacity but then balances the risk of sedated feeding - of which there are several set out at [15] - with an assessment of LV's wishes, reminding herself that LV is an adult so as not to give undue weight to LV's mother's views. She concludes at [57]
"I have thought long and hard about all of those risks and detriments as I weigh the balance. The point about the balance however is to look at what it is that falls on the other side. Here when I look at the other side, at what lies in the balance against all that is risky; all that which in other circumstances would be an intolerable affront to her autonomy, what I contemplate is her imminent death."
She therefore makes the declarations requested. 
Read the judgment on Bailii