Munby J gave reasons for his decision to permit AE’s treating doctors to infuse her with blood, if necessary, notwithstanding the existence of a living will in which she refused, in advance, to accept the transfusion of blood. He said: ‘There is now quite a substantial body of authority relevant to the issues I have to consider. It is all too well-known to require either description or much analysis: see In re T (Adult: Refusal of Treatment) [1993] Fam 95 , Airedale NHS Trust v Bland [1993] AC 789 , In re C (Adult: Refusal of Treatment) [1994] 1 WLR 290 , Re MB (Medical Treatment) [1997] 2 FLR 426 , St George’s Healthcare NHS Trust v S [1999] Fam 26 , Re AK (Medical Treatment: Consent) [2001] 1 FLR 129 and Re B (Consent to Treatment: Capacity) [2002] EWHC 429 (Fam), [2002] 1 FLR 1090.
i) A competent adult patient has an absolute right to refuse consent to any medical treatment or invasive procedure, whether the reasons are rational, irrational, unknown or non-existent, and even if the result of refusal is the certainty of death. I agree with Professor Andrew Grubb’s observation (see [2002] Med L Rev 201 at 203) that: ‘English law could not be clearer. A competent adult patient once properly informed, has the unassailable legal right to refuse any or all medical treatment or care.
ii) Consistently with this, a competent adult patient’s anticipatory refusal of consent (a so-called ‘advance directive’ or ‘living will’ ) remains binding and effective notwithstanding that the patient has subsequently become and remains incompetent.
iii) An adult is presumed to have capacity, so the burden of proof is on those who seek to rebut the presumption and who assert a lack of capacity. It is therefore for those who assert that an adult was not competent at the time he made his advance directive to prove that fact.’
Judges:
Munby J
Citations:
[2003] EWHC 1017 (Fam)
Links:
Jurisdiction:
England and Wales
Cited by:
Cited – Jenkins, Regina (on The Application of) v HM Coroner for Portsmouth and South and Others Admn 11-Dec-2009
The deceased had contracted gangrene, but not sought treatment, and he died of it. The claimant challenged the narrative verdict saying that it was perverse and that the only proper verdict was unlawful killing by his partner, a nurse who had . .
Lists of cited by and citing cases may be incomplete.
Health
Updated: 09 August 2022; Ref: scu.235735