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seAp IMCAs support Judge's ruling against forced life saving amputation for mentally ill man

Posted: 5th October 2015

seAp advocacy applauds the recent High Court judgment which ruled that a mentally ill man with diabetes should not be forced to undergo a life-saving amputation by an NHS trust even though his condition would lead to death.  The judge ruled that it would not be in the individual’s best interests to take away his little remaining independence and dignity in order to replace it with a future for which he understandably had no appetite and which could only be achieved after a traumatic and uncertain struggle that he and no one else should have to endure. 

He concluded that “In some cases, of which this is an example, the wishes and feelings, beliefs and values of a person with a mental illness can be of such long standing that they are an inextricable part of the person that he is. In this situation, I do not find it helpful to see the person as if he were a person in good health who has been afflicted by illness. It is more real and more respectful to recognise him for who he is: a person with his own intrinsic beliefs and values”

This case brings to mind a similar case supported by a seAp Independent Mental Capacity Advocate (IMCA)  in Portsmouth.  The case did not go to court, however, the IMCA was able to support the individual to put their views across and get the outcome they desired. 

Peter (not his real name) had not been managing his diabetes well for quite some years and had not sought proper medical treatment up to his admission to an acute hospital.  The surgical team referred to IMCA because they were making a decision about amputating both his legs below the knee in order to save his life.  The team were aware that Peter did not want this treatment but they also had to consider their duty of care towards him.  

The IMCA was able to represent Peter’s particular views by showing  that these were views that he had held all of his life.  Peter was able to explain that he had been put into a psychiatric hospital as a child and had never believed in the expertise of doctors or medical professionals.  Peter mentioned that when he saw programmes on the TV about surgeons performing life saving heart surgery he just thought that they never showed the people who had died under their care and the ones who had not been saved. 

The client’s GP was able to confirm that Peter had never sought the medical treatment he needed even when it was pointed out to him that he was at great risk to his health and survival. The GP also explained that Peter had, for many years, refused to accept any advice or information from doctors or health professionals - because he did not accept that their advice was of value to him. 

The IMCA discussed with Peter the reality of what would happen if the surgical treatment was not given - that he would have a prolonged and painful ending to his life.  Peter’s view was that this was his preferred choice and that he did not want the surgery and all the necessary treatment and support that follows.

Peter’s healthcare team viewed his wishes, feelings, beliefs and values in the same way as the judge.  In this case--that his views were an inextricable part of the person he is.  

This case highlights the important role that IMCAs have in gathering evidence and supporting individuals to put across their views.   The IMCA service played a critical  role in enabling the decision makers to support Peter’s choice.



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