Choice and Capacity - a beginning draft question raised and to be answered.

" E.G. .... It's their choice to dress like that, to live in that mess, to spend a thousand pounds on fireworks,
to continue to live in a style that indicates the patient is not in charge of their lives and is placing themselves at risk .... "

Yes, it is ... unless the actions taken are accompanied by indications that the illness is continuing, as demonstrated by their life style, as observed by others.

'yes, it is ... unless the patient is showing, in spoken and in other signs of behaviour which point to
a level of illness influencing those decisions.

Case law 'C' may act as a starting decision - C develped gangrene in a leg, whilst detained . The Responsible medical Officer said he was too lacking in capacity because of schizophrenia to ba able to choose that. He believed he was aa medical doctor. He refused amputation.
A surgeon gave his opinion that the leg should be amputated. The TRust went to Court to be able to proceed against the chioice of C. The Court heard eveifdence that 'in the meanwhile' waiting for the Court appearance befoe prodceedimng to amputate the leg was healing under anti-biotice treatment. The surgeon now gave adiffeent view to the Court - ampuation was not necessary. The Trust asked the cOurt to decide about the capacity of C to decline ampuatation. The Court decided he had choice, had capacity.

Some years later C made his will leaving his estate to ... 'C' .
The lawyer who spoke for 'C' at the original Court hearing, reflected after the Will, that 'C' likely did not have capacity at the original hearing.

and the 'Bournewood' matter ... HL ws judged not to have capacity to indicate he wanted to be discharged to the care of his community carers, despite making attempts too leave his confinement.
He was not considerd to be deprived of his liberty to prevent him leaving to the community carers.
He was eventually detained under the MHA and the managers of the detaining Trust discharged him

...... and this sort of worry

...

'Mr Frankum was seen regularly by professional staff and was assessed for detention under the Mental Health Act
several weeks before the incident, because of family concerns about his condition and his lifestyle.'
It added: 'However there was not sufficient evidence of a risk to himself or others
to detain him against his will.'
' But after failing to take his medication for a number of weeks, he killed landscape gardener Mr Quelch, who was asleep in bed with his two-year-old son.
Frankum told paramedics and police at the scene: 'You don't want to go in there,
there's stuff you don't want to see. There's a bloke in there, I've stabbed him about 10 times.
He wouldn't die. There are three children in there; they"re all OK.'
He told police that 'MI5 sent him down to kill Danny', adding: 'Can you get me a can of Coke - there are some in the fridge?'

Why was Harkin, who had been committed eight years ago for stabbing his baby brother to death, was being held in a low-security institution.
Staff at Hayes Hospital near Bristol were not allowed to be alone with Harkin
because he was considered to be such a threat.
But he was allowed to keep a collection of pornography and horror films and was taken by staff to see violent films

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