X NHS Foundation Trust v RH [2024] EWCOP 150

Application by hospital trust concerning capacity and best interests of RH, who needs treatment for kidney failure but has a form of schizophrenia. 

RH is 40 years old and currently detained under s3 of the MHA 1983. He has a form of schizophrenia, which is characterised by disorganised behaviour and speech, mood incongruence, hallucinations and delusions. RH has also been diagnosed with declining kidney function which requires surgical intervention. The applicant Trust was seeking orders that RH lacks capacity to make decisions about his treatment and it was in his best interests to undergo the proposed urological surgery under general anaesthesia.

After reviewing the evidence and the relevant law, the judge agrees RH lacks capacity, partly as RH's delusions lead him to think there is nothing wrong with him and the hospital wants to remove his kidneys and kill or harm him. She goes on to accept the care plan is in his best interests as the kidney problem is caused by a blockage and could be cured with a simple incision, a decision made easier as RH's current medication for schizophrenia is proving to be beneficial. Finally the judge comments on the procedural history of the application at [5-14] which had been unhelpful and is described at [78] as 'frenzied'.

Read the judgment on the National Archive