South West Hertfordshire Health Authority v KB
| Jurisdiction | England & Wales |
| Judgment Date | 1994 |
| Date | 1994 |
| Court | Family Division |
Medical treatment – adult patient – patient suffering from anorexia nervosa – whether anorexia nervosa was a mental disorder – whether naso-gastric feeding was medical treatment of the patient.
The patient was detained in hospital under s 3 of the Mental Health Act 1983 having suffered from anorexia nervosa for 4½ years. In her own opinion she was fat and needed to reduce her weight which at 18½ years of age was 38 kg. In the opinion of the consultant physician and the consultant psychiatrist in whose care she was, her anorexia amounted to a severe mental illness. She had taken no food or drink for several days. If she continued to refuse food she was expected to die within, at most, 21 days. On previous occasions she had been fed without her consent with a naso-gastric tube after completion of a form under s 58 of the Mental Health Act 1983, based on two medical opinions. The Mental Health Commission had recently formed the view that for this patient naso-gastric feeding was food rather than medicine, and told one of the doctors to stop using the form. The health authority had therefore applied by originating summons for a declaration of the lawfulness of naso-gastric feeding without the consent of the patient.
Held. Section 63 of the Mental Health Act 1983 stated that the consent of the patient was not required for any medical treatment given under the direction of a responsible medical officer for a mental disorder. Feeding by naso-gastric tube was medical treatment (see Airedale NHS Trust v Bland[1994] 1 FCR 485), and was an integral part of treatment for the mental disorder of anorexia nervosa from which the patient suffered. It was covered by s 63. A declaration would be made accordingly.
Re C (An Adult: Refusal of Treatment)[1994] 2 FCR 151 distinguished. Statutory provision referred to:
Mental Health Act 1983, ss 3, 58 and 63.
Cases referred to in judgment:Airedale National Health Trust v Bland[1994] 1 FCR 485; [1993] AC 789; [1993] 2 WLR 316; [1993] 1 All ER 821.
C (An Adult: Refusal of Treatment), Re[1994] 2 FCR 151.
Adrian Hopkins for the health authority.
Cherie Booth for the patient.
Peter Jackson for the Official Solicitor.
Judgment Mr Justice Ewbank.K is now 18½ and is therefore grown up. She has had anorexia nervosa from about the age of 14. She has been treated in various places but on 7 September 1993 she went to Watford General Hospital under s 3 of the Mental Health Act 1983. This provides that an admission for treatment may be...
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