King's College Hospital NHS Foundation Trust vs South London and Maudsley NHS Foundation Trust and GF

This case concerned an application by King's College Hospital NHS Foundation Trust to the Court of Protection regarding the medical treatment of GF, a patient with paranoid schizophrenia, who required urgent surgery.

TLDR:

• GF was diagnosed with paranoid schizophrenia and had a severely infected leg.
• The court had to determine whether GF had the capacity to make decisions about his treatment.
• The court found that GF lacked capacity and that it was in his best interests to undergo above-knee amputation.

King's College Hospital NHS Foundation Trust filed an application supported by the South London and Maudsley NHS Foundation Trust concerning GF, a 60-year-old patient with paranoid schizophrenia. GF was admitted to the hospital with a severely infected leg, and the medical team proposed an above-knee amputation to prevent further deterioration and death.

GF had a long-standing history of paranoid schizophrenia and was intermittently non-compliant with his medication. Upon admission, he exhibited delusional thoughts and was disoriented. Despite treatment with intravenous antibiotics, his condition did not improve, and the medical team recommended urgent surgery.

The court had to determine whether GF had the capacity to make decisions about his medical treatment. The evidence presented by Dr. B, a Consultant Psychiatrist, indicated that GF was unable to understand, retain, or weigh the relevant information regarding his condition and treatment due to his paranoid schizophrenia and possible delirium.

The court found that GF lacked the capacity to make decisions about his medical treatment and that it was in his best interests to undergo the recommended surgery. The court emphasized the importance of considering all relevant circumstances, including GF's wishes and feelings, the medical evidence, and the views of his family members, who supported the proposed treatment.

The court concluded that the above-knee amputation was the only viable option to preserve GF's life and that it was lawful and in his best interests to proceed with the surgery. The court also noted the importance of publishing a judgment to provide transparency and a record for GF.

Legal representatives: Francesca Gardner (instructed by Bevan Brittan LLP) for the Applicant and First Respondent, Jake Rylatt (instructed by The Official Solicitor) for the Second Respondent.

Judicial Panel: Ms. Justice Henke

Case Citation Reference: [2024] EWCOP 20