University College London Hospitals NHS Foundation Trust v HER & Anor[2024] EWCOP 25

Best interests decision concerning HER's medical care where he sister, SR, was opposed to the Trust's recommended treatment.

HER is 53 years old and lives at a supported living placement with a 24 hour package of care. A stroke-like episode in childhood left her with learning difficulties and epilepsy. She has also been diagnosed with a metabolic disorder which causes episodes of acute encephalopathy a few times a month and raises the risk of Sudden Unexpected Death. It is the treatment for this condition at the heart of this application. SR, disagreed with the Trust's treatment plan and presented the court with extensive documentation setting out her views.

Senior Judge Hilder first considers the status and admissibility of SR's evidence, who describes herself as 'an expert by experience'.  She decides the practical approach is to admit SR's evidence about HER's reactions as evidence of fact but disregard her opinions on the medical treatment. She then reviews the differing opinions on the treatment plan and the actions of SR that have caused the trust to seek restrictions on her attendance. At [70], SJ Hilder concludes; HER lacks capacity to decide on her treatment for the OTC deficiency and epilepsy; it is in HER’s best interests to be treated according to the amended plan filed; it is NOT in HER’s best interests for SR to attend her appointments; though she will not make injunctive orders, so SR can demonstrate she will abide by the Court’s decision.

Read the judgment on the National Archive