University Hospitals of Derby and Burton NHS Foundation Trust & Anor v MN (medical treatment : Mental Capacity Act 2005) [2021] EWCOP 4

Application by the NHS trust to examine the P and if, clinically appropriate, to remove tumours ​under general anaesthetic. An interim order was made pending a final hearing in March.

The P attended his GP in August 2020 because he was passing a coffee-like substance from his urethra. Whilst he felt able to co-operate with an ultrasound performed in November 2020, the P has subsequently resisted further investigations or treatment. The P's treating urologist considers that the P's symptoms strongly indicate that he has bladder cancer, but absent a CT scan, this is not confirmed. In the event the P has bladder cancer, if left untreated, there is an as yet unquantifiable risk that he will suffer a painful deterioration due to blood clots forming in his bladder and could be prevented from urinating. While the precise timescales are unknown, without a cystoscopy procedure, the P may experience a quicker and more unpleasant death resulting from a cancerous growth metastasising. This was an application for the Trust to examine the P and treat him accordingly.

The court made an interim order that was only operative (pending the final hearing) if all of the following conditions were met:

1. The P is in pain and/or discomfort and/or is unable to urinate;
2. The P's views have been canvassed regarding having emergency treatment (it having been explained to him that such treatment would release him from pain and/or discomfort and/or would enable him to urinate);
3. The emergency treatment would include releasing any blood clots in his bladder (or other clinically indicated and operable obstruction) preventing him from urinating;
4. The P continues to express a resistance to emergency treatment.

A final hearing was to be listed in March 2021.

Read the full text of the judgment on Bailii