The legal profession is often portrayed as a callous, self-serving profession, more interested in profits than people. However, once in a while a case comes along that demonstrates that judges and lawyers do, in fact, care about people, just as much as their brothers and sisters in the medical profession.
The Court of Protection case Re QQ, heard by Mr Justice Keehan last March but only just published on Bailii, is one such case. It concerned an application by a psychiatric hospital in relation to a 26 year-old woman (referred to in the judgment as ‘QQ’) who has a diagnosis of an emotionally unstable personality disorder and schizophrenia. She also has certain belief systems which are not explained in the judgment, but which clearly have an impact upon her wishes regarding medical treatment.
In addition to her psychiatric problems the woman also suffers recurrent episodes of deep vein thrombosis (DVT). These cause her pain, but could lead to far more serious consequences, even death. The hospital wanted to treat QQ with anticoagulant medication, but QQ refused to consent to this.
There was a further complication in that QQ is prone to self-harm, including inserting objects into her stomach. Obviously, if this leads to her bleeding then she would have to be taken off anticoagulant.
Before coming to his decision Mr Justice Keehan went to the hospital to see QQ. He met with her briefly, introduced himself and heard what QQ wanted to say to him regarding her treatment. QQ initially told him that she would take the medication by tablets, then said that she was not sure and then said that it would depend upon how she felt and her mood. She also told him that her acceptance or not of the need for her to receive anticoagulant medication varied and depended again upon her mood, by which he took it to mean the difficulties and belief systems that she has.
Mr Justice Keehan accepted the evidence of QQ’s treating clinician that she lacked capacity to make decisions on the issue of her treatment in relation to receiving anticoagulation medication, which he was in no doubt it was in her best interests to receive.
“I am satisfied that because of QQ’s mental health difficulties and her belief systems she is not able, now or in the past, to weigh the information that she receives. She is not able to weigh and reach a consistent conclusion on the medical need for her to receive this medication. Nor is she able to remain consistent in her ability to cooperate with the clinicians treating her, whether in relation to taking medication orally or by way of injection.”
Accordingly, he was quite satisfied that it would be in QQ’s best interests to receive the anticoagulant medication. As she had indicated to him that she was concerned about receiving injections, he directed that in the first instance the medication should be administered by way of tablets, but he did explain to QQ at the hospital that:
“…if she were not to be consistent in taking those tablets twice daily when she commenced on that form of treatment then it would be necessary for her to be treated by way of injection because the risk of her suffering further episodes of DVT and the potentially life-limiting consequences are such that she needs this anticoagulant medication to reduce those risks.”
What strikes me about this short judgment is just how much Mr Justice Keehan clearly cared about QQ’s welfare, listening to her and taking notice of her concerns. QQ is obviously receiving an enormous amount of dedicated care from the medical professionals and other health service personnel attending to her, but the judgment demonstrates that the legal profession can be caring as well.
The full judgment in Re QQ can be found here.