NHS England to face court over patient kept alive by blood transfusions

This article was taken from: https://www.theguardian.com/society/2017/oct/03/nhs-england-to-face-court-over-patient-kept-alive-by-blood-transfusions

By:Owen Bowcott Legal affairs correspondent

Mother of woman with eating disorders wants ruling on whether monthly treatment is in daughter’s best interests

NHS England is to be questioned in court about its treatment of a woman with severe eating disorders who is being kept alive by monthly blood transfusions.

The patient, who is in her 30s, is being cared for in a London hospital, the court of protection has been told, but wants to return home to die if she is not given additional psychiatric care.

The highly unusual and complex medical case has been brought to court by her mother. She is asking a judge to rule whether it is in her daughter’s best interests to continue receiving blood to boost her haemoglobin levels.

The medical team treating the woman, who cannot be identified, are not agreed on a diagnosis, the court heard; some doctors suggest she is suffering from a “personality disorder”. She disputes that diagnosis.

The patient is said to have become more distressed by the monthly transfusions. There is disagreement over how much restraint is required to ensure she receives the blood.

Her mental capacity to make decisions in her own interest is an issue the court of protection will have to resolve. Her mother has been appointed as her litigation friend and her father has been made a party to the proceedings. Both were in court.

Her father told the hearing that she was “very ill indeed”. The last time he visited her, he said, “I really did feel that she might die. I would ask that we move as quickly as possible.”

The woman is not suffering from anorexia and is taking some fluids and food. She is detained under the Mental Health Act. Part of the medical dilemma relates to confusion over where the woman should be sent for treatment.

The local NHS trust was represented in court but not NHS England, which is ultimately responsible, it was said, for dealing with such complex cases.

Mr Justice Newton, hearing the case, ordered that the parties, including NHS England, attend a hearing in 14 days to give evidence about the woman’s treatment.

“There are a lot of disagreements about diagnosis,” the judge said. “I’m not sure diagnosis is always helpful. It’s really a question of how best to achieve [effective medical treatment].”

The court of protection deals with those who cannot manage their own affairs. They are usually represented by a close relative or a lawyer.

Sir James Munby, the judge in charge of the family court and the court of protection, has ordered that there should be greater transparency in the way the courts operate.