Doctors cannot amputate a man’s foot despite the fact it would save his life, the Court of Protection has ruled.
In Wye Valley NHS Trust v B, the 73 year-old man, ‘Mr B’, suffered from paranoid schizophrenia. He would often hear voices which he believed were angels and the Virgin Mary. He also suffered from Type II Diabetes, although his management of this disease was “at best patchy”.
Mr B later developed “a chronic foot ulcer” which would not heal. His foot then became “not only infected but putrefying and the bone itself had become infected”. Doctors believed that the only way to save Mr B’s life was to amputate his foot.
However, he opposed amputation “in the strongest possible terms” despite knowing it meant he would likely die. In response, the NHS Trust responsible for his care applied to the Court of Protection for permission to perform the surgery despite his objections.
Mr Justice Peter Jackson heard the application. Before his decision, he and a court clerk visited Mr B to talk about it. During this meeting, he told the judge that he was “not afraid of dying” because he was convinced that he was going to heaven.
He said:
“I don’t want it. I’m not afraid of death. I don’t want interference. Even if I’m going to die, I don’t want the operation.”
The judge noted that, if he allowed the doctors to perform the surgery, Mr B would have to be sedated beforehand to overcome his resistance and afterwards “to help him with his inevitable feelings of outrage and distress”. He also expressed concern that amputating the foot could cause further damage to his mental state as it would serve as “a continual reminder that his wishes were not respected”.
He added that Mr B’s “fortitude in the face of death … would be the envy of many people in better mental health”. Therefore, he ruled that “an enforced amputation would not be in Mr B’s best interests” and although he stated they were right to bring it, he dismissed the NHS Trust’s application.
Mr Justice Jackson concluded his judgment with praise for “the high standard of care and treatment” the doctors had provided for Mr B.
To read the full judgment, which is frankly the most moving and magnificent example of the highest standards applied by the Judge the advocates and the respective professionals involved in this case click here.
