Jurisdiction(s):
United Kingdom

Best interests in anorexia nervosa: Court of Protection rejects forced feeding, authorises hospice end-of-life care, weighing Articles 2, 3 and 8 ECHR and MCA 2005 autonomy

Published on: 14 February 2024

Published by a LexisNexis Private Client expert

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Article summary

North East London NHS Foundation Trust v Beatrice (by her litigation friend the Official Solicitor) and another (No 2) [2023] EWCOP 60

What are the practical implications of this case?

This is Mr Justice Mostyn’s assessment of B’s best interests, measuring the stark alternatives of life and death through five components [(1–5) below]. The two principal forces are:

the robust presumption for preserving life, reflecting the categorical terms of Article 2 ECHR in both its mandatory and prohibitory dimensions, and the wording of MCA 2005, s 4(5) (paras [2, 3, 11])
a core facet of personal liberty—B’s wishes, feelings, beliefs and values. The Official Solicitor submitted, and Mostyn J “strongly agrees”, that the “fundamental precept” is that we are “free people entitled to live our lives as we choose, subject only to general lawful constraints”, even where capacity is absent (paras [4]–[6]; Articles 3 and 8 ECHR; MCA 2005, s 4(6))

Further elements to be balanced in this characteristically evaluative exercise (and not a discretion) are:

(3) the views of B’s family
(4) B’s overall prognosis
(5) the opinions of the treating clinicians

Propositions which guide the...

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