The mother of a young man with autism and learning disabilities should no longer serve as his deputy, the Court of Protection has ruled.
The case concerned ‘X’, a 25 year-old man who now lives in a residential home. Around his third birthday, he was diagnosed with “autistic tendencies”, on the basis of his slow development, poor language skills and special educational needs. His mother blamed his difficulties on the MMR vaccine and a bout of gastroenteritis, and became convinced that a restricted diet would be beneficial. She reported major improvements following the exclusion of gluten and yeast from his meals, saying that “language difficulties became his primary difficulty” at that point.
However, X subsequently received an MMR booster shot and deteriorated significantly, she claimed. He was withdrawn from school and educated at home for a number of years.
He later developed eczema and suspected food allergies. He continued to experience significant social and psychological difficulties, regressing to an “almost catatonic state” during a visit to the A&E department of a local hospital. In 2009 he was expelled from college after his behaviour deteriorated to the point of causing major disturbances. Sitting in the Court of Protection, District Judge CHJ Hilder explained that these had included:
“…extremely hyped up behaviours…[including] jumping on cars, constant screaming and shouting often lasting all night, hitting and charg[ing] at staff and indeed fellow residents.”
In January 2010, X’s mother, identified in the judgement as ‘AY’, was appointed her son’s deputy for both welfare issue and his financial affairs.
Meanwhile, X had been sectioned under the Mental Health Act and subsequently moved to a residential care home. A social worker noted continuing disagreements between AY and the medical professionals treating X regarding his condition. He continued:
“…concentration only on [X’s] health needs rather than those in regard to his mental state has not achieved stability for [X] in recent years.”
A dispute arose between AY and the doctors when a decision was made to cease the use of dietary supplements and instead use psychotropic drugs. She claimed that he became “passive and inactive” as a result.
She went to court seeking an order to “to support and uphold her decision to refuse consent” for the use of drugs on her son. She also sought clarification of her authority as deputy to insist on the use of dietary supplements. X’s then GP refused to reintroduce the supplements.
X assaulted a member of staff and he was again sectioned in a special facility, this time for a month, before being sent back to his care home. He was sectioned for a further period later the same year.
AY’s legal proceedings continued, but were hampered by the absence of a litigation friend for X to represent his interests. AY sought the involvement of a number of experts, including a psychiatrist, a gastroenterologist and a neurologist, at a hearing to establish the true nature of X’s physical problems.
The Official Solicitor agreed to act as a litigation friend for X but disagreements over appointment of the experts persisted until these were eventually agreed with the help of Judge Hilder.
Meanwhile, X’s restrictive diet continued. The mother made further efforts to prevent the of psychotropic drugs and the complex series of legal manoeuvrings continued.
A new doctor took over treatment of X and changed his medication. Judge Hilder explained:
“It is common ground between the parties that X’s behaviour thereafter showed significant improvement. He became more communicative, more tolerant of frustration, less troubled by unseen stimuli, and more reciprocal in his affective interaction with others.”
At a hearing held in January last year, further “abundant dispute” between AY and the doctors treating her son was apparent. The local authority began to explore the possibility of a community placement, but were concerned that the mother’s preoccupation with dietary supplements would lead her to try and interfere with this. They therefore applied for her status as deputy to be revoked and it was subsequently suspended.
X was moved to a new community placement with the agreement of his mother, which he shared with eight other “service users”. The house had its own nutritional professionals.
The Court of Protection was asked to conduct a fact-finding on the mother’s claims in relation to X’s diet, and on the restoration or removal of her deputyship.
Judge Hilder said X’s mother showed little sign of compromise.
“I can find no indication that AY is likely to change her views as to the need for dietary restriction and supplements in the future.”
She noted that there had been no noticeable deterioration in X’s behaviour or physical health since he had begun a completely unrestricted diet. Any return to such restrictions would be, she ruled, “an infringement of X’s freedoms”, while his mother’s insistence on dietary supplements was an “imposition” she added. There was no evidence of benefits to be gained “from either the infringement or the imposition”, Judge Hilder declared.
Turning to the mother’s role as deputy, the Judge declared briskly that she had worked against X’s interests while in the role.
“AY’s views run counter to the generally accepted approach in respect of treatment for autism, yet she has pursued, and as I have found will continue to pursue, those views to the point of placing unworkable strain on those responsible for X’s day to day care.”
Her deputyship would be revoked, Judge Hilder ruled, but said she would nevertheless still be allowed to contribute to “the process of welfare decision–making for her son.”
Re X is available online here.