Kings College Hospital went to the Court of Protection to try and force a 50 year old lady to receive renal dialysis after an attempted suicide. She did not want to live because she feared getting old. She had been diagnosed by her psychiatrist as having a mental disorder – a narcissistic, personality disorder which made her unable to consider the effects of her suicide on others such as her daughters.
She had lived a life of excess and had had four husbands and numerous lovers. She was impulsive and unable to think of others. She was, according to one of her daughters [who supported their mother’s decision] ‘the life, soul and sparkle of any party.’
Her life started to go downhill when she was diagnosed a year ago with breast cancer. She refused treatment for the cancer because she was worried about the effects of chemotherapy on her appearance and refused surgery in case it would affect her appearance in a bikini.
She said that she would rather ‘die than suffer from ill health, poverty and lose her high life.’
King’s College Hospital NHS Foundation Trust believed she could fully recover but she stated that she would then ‘throw herself under a train.’
The judge, Mr Justice MacDonald concluded that her decision to refuse treatment might be considered “unwise”, or even “immoral” and would ‘horrify many,’ but was not beyond her capacity.
Current law gives people the right to refuse treatment even if not treating leads to their death. It is considered wrong to force treatment on someone who refuses it even in some cases of mental illness. The right to refuse lifesaving treatments is not the same as the right to receive treatment that would end a life – assisted suicide, which is still illegal in this country. Ethicists often argue that there is often a fine line between an ‘act’ and an ‘omission’ but in legal terms the difference is huge.
In a similar case in 2014 doctors at a UK hospital were faced with a medical dilemma after woman with paranoid schizophrenia, whose infected foot became mummified and fell off, refused to undergo an operation. Mr Justice Peter Jackson ruled that her mental illness had not robbed her of the power to make rational decisions and told medics they would have to abide by her wishes.
The judge said: “The freedom to choose for oneself is a part of what it means to be human”.