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England and Wales Court of Protection Decisions |
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You are here: BAILII >> Databases >> England and Wales Court of Protection Decisions >> Newcastle-Upon-Tyne City Council v TP (Best Interests) [2016] EWCOP 61 (21 December 2016) URL: http://www.bailii.org/ew/cases/EWCOP/2016/61.html Cite as: [2016] EWCOP 61 |
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SITTING AT TEESSIDE COMBINED COURT
B e f o r e :
Sitting as a Nominated Judge of the Court of Protection
____________________
NEWCASTLE-UPON-TYNE CITY COUNCIL | Applicant | |
-and- | ||
TP (By her litigation friend the Official Solicitor) | Respondent |
____________________
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Counsel for the First Respondent:
Solicitors for First Respondent Cartwright King MISS GARDNER
____________________
Crown Copyright ©
HER HONOUR JUDGE MOIR:
"An act done or decision made under this Act for or on behalf of a person who lacks capacity must be done or made in his best interests."
"The person's age or appearance and a condition of his or an aspect of behaviour which might lead others to make unjustified assumptions about what might be in his best interests."
"The court must consider as far as reasonably ascertainable:
(a) The person's past and present wishes and feelings and in particular any relevant written statement made by him when he had capacity;
(b) The beliefs and values that would be likely to influence his decision if he had capacity; and
(c) The other factors that he would be likely to consider if he were able to do so."
"He must, so far as is reasonably practicable, permit or encourage the person to participate or to improve his ability to participate as fully as possible in any act done for him or any decision affecting him."
TP has been seen and spoken to frequently by her solicitor and I have visited TP. She has not attended court but has not expressed a wish to so do. I am satisfied that Miss Gardner has been at pains to represent and put forward TP's views to the court.
"The continuing overruling of TP's wishes is uncomfortable. However, there are considerable concerns. At the time of my initial report I had concerns that the protection may be worse than the harm. This is certainly how TP views the situation. I have put some of my concerns around this issue down to what I believe to be the inappropriate nature of the placement. With TP's mood lifting and actually liking the placement where she is and her consistency remaining, this leads me to think that the balance is shifting further towards the theory that the protection itself may be worse than the harm."
"Finally, insofar as Sir Alan Ward and Arden LJ were suggesting that the test of the patient's wishes and feelings was an objective one, what the reasonable patient would think, again I respectfully disagree. The purpose of the best interests test is to consider matters from the patient's point of view. That is not to say that his wishes must prevail, any more than those of a fully capable patient must prevail. We cannot always have what we want. Nor will it always be possible to ascertain what an incapable patient's wishes are. Even if it is possible to determine what his views were in the past, they might well have changed in the light of the stresses and strains of his current predicament. In this case, the highest it could be put was, as counsel had agreed, that 'It was likely that Mr James would want treatment up to the point where it became hopeless.' But insofar as it is possible to ascertain the patient's wishes and feelings, his beliefs and values or the things which were important to him, it is those which should be taken into account because they are a component in making the choice which is right for him as an individual human being."
"The fact is that in this type of case the court is exercising an essentially protective jurisdiction. The court should intervene only where there is a need to protect a vulnerable adult from abuse or the real possibility of abuse..."
I note that this case was about a vulnerable adult.
"The jurisdiction is to be invoked if, but only if, there is a demonstrated need to protect a vulnerable adult. And the court must be careful to ensure that in rescuing a vulnerable adult from one type of abuse it does not expose her to the risk of treatment at the hands of the State which, however well intentioned, can itself end up being abusive of her dignity, her happiness and indeed of her human rights. That said, the law must always be astute to protect the weak and helpless, not least in circumstances where, as often happens in such cases, the very people they need to be protected from are their own relatives, partners or friends."
Clearly these words are relevant in relation to those persons who are incapacitated.
"There is one final point to be made. The court, as I have said, is entitled to intervene to protect a vulnerable adult from the risk of future harm – the risk of future abuse or future exploitation – so long as there is a real possibility, rather than a merely fanciful risk, of such harm. But the court must adopt a pragmatic, common sense and robust approach to the identification, evaluation and management of perceived risk."
"A great judge once said, 'all life is an experiment,' adding that, 'every year if not every day we have to wager our salvation upon some prophecy based upon imperfect knowledge'... The fact is that all life involves risk, and the young, the elderly and the vulnerable, are exposed to additional risks and to risks they are less well equipped than others to cope with. But just as wise parents resist the temptation to keep their children metaphorically wrapped up in cotton wool, so too we must avoid the temptation always to put the physical health and safety of the elderly and the vulnerable before everything else. Often it will be appropriate to do so, but not always. Physical health and safety can sometimes be bought at too high a price in happiness and emotional welfare. The emphasis must be on sensible risk appraisal, not striving to avoid all risk, whatever the price, but instead seeking a proper balance and being willing to tolerate manageable or acceptable risks as the price appropriately to be paid in order to achieve some other good – in particular to achieve the vital good of the elderly or vulnerable person's happiness. What good is it making someone safer if it merely makes them miserable?"
"Judges who try family cases of all types know how infinitely variable are the considerations that need to be considered in determining what is in somebody's best interests. Norms and values of society change over time, as do the ways available to attempt to meet people's needs. There can be no substitute for a careful analysis of the evidence in the particular case. Factual disputes have to be determined and the recommendations and opinions of professionals evaluated in order to arrive at a conclusion. This is the everyday work of those who try cases involving children and increasingly it is becoming a routine exercise for those who sit in the Court of Protection. I would not wish to impose upon that exercise a structure which is not contained within the Act which confers the various powers and duties and dictates how they should be exercised."
"Here is a checklist that might have appeared in section 4 but did not. I have stolen most of it from existing well-tried checklists. It requires a decision maker in personal welfare cases to consider all the relevant circumstances and, in particular, the following:
- Past and present wishes and feelings;
- Beliefs and values;
- Age, background, race, culture and language;
- Physical, emotional and educational needs;
- The extent to which they are being met; Relationships with relatives and other significant persons;
- The promotion of independence;
- The preservation of dignity;
- Harm or likelihood of harm;
- The effect of any change of circumstances;
- The range of services that are available; and finally, in cases concerning life preserving treatment,
- The right to life."
"Control in its nicest way throughout her life. When the control from her parents was gone it left a big gap and it was a big change that TP had to start making decisions. Then along comes FW, not a nice control. The control from her parents was about TP as they saw it then. This control from FW is about FW's interests. It is about him. TP is now hooked into FW. It is a dynamic of that control."
I find TP has opted for what is familiar to her. She knows Gosforth, she was residing with FW in Gosforth in a similar type of property to what she was used to and decisions were being made for her. It is what she knows. Rebecca Horsfall and Dr Hughes referred to their experience of people with learning disabilities having a concrete way of thinking and TP being unable to organise her thoughts to consider all the available options. TP is a sociable person and it is said that she craves, indeed needs, the care and support of others.
"Over time she will have to let go of her wants and desires and allow herself to be dominated by another person. There is a risk to mood which might lower so that she would become depressed. The risk is more so to self-esteem. It is domestic violence without the violence."
"The decision is to be welcomed for a number of reasons. It should ensure that proper recognition is given to the right to private life of adults who lack capacity. Concepts of autonomy and self-determination have not, for obvious reasons, featured strongly in cases involving children and there can be a tendency to rely on the approach taken in family proceedings even though the MCA concerns adults. Promoting autonomy and self-determination are clearly of much greater significance in relation to incapacitated adults. While there are no doubt similarities between the functions of a judge in family proceedings and in MCA welfare proceedings, adults are not children and caution is required in drawing analogies between two groups or assuming that approaches relevant to one group can be translated to the other."
"If she returns to FW he 'wins' and he becomes her saviour. He has saved her from the nasty Social Services. He becomes her hero, thus reinforcing the very negative situation where TP identifies with him and his agenda. The Stockholm Syndrome, where TP's real identity is lost."
In these circumstances I find that TP is meeting FW's needs and her needs are subsumed in his and his need to gain control, as indeed he has demonstrated by cutting her off from any outside influence, such as her sisters, her familiar GP and community support.