Medical Treatment: Decisions and the Law

5. Restraint and Deprivation of Liberty

Co-authored by Claire Watson QC and Anna Tkaczynska.

Contents

  • A Introduction  5.1
  • B Restraint  5.8
  • Restraint permitted under the MCA 5.11
  • The statutory defence 5.11
  • Limits to the statutory defence 5.14
  • Necessity 5.15
  • Proportionality and restraint 5.16
  • Restraint and Article 3 ECHR 5.18
  • Covert medication and deception  5.23
  • C Deprivation of liberty  5.24
  • Background: ‘the Bournewood gap’ 5.24
  • What is a ‘deprivation of liberty’? 5.29
  • Cheshire West  5.29
  • The position prior to the Supreme Court decision in Cheshire West 5.30
  • The ECtHR definition  5.32
  • The decision in Cheshire West 5.35
  • The facts in MIG and MEG 5.35
  • The facts in P v Cheshire West 5.38
  • The reasoning in Cheshire West  5.40
  • Identifying a deprivation of liberty: ‘a gilded cage is still a cage’ 5.45
  • The acid test  5.52
  • The impact of the decision in Cheshire West 5.53
  • Identifying a potential deprivation of liberty in the hospital context  5.55
  • Place and duration of the patient’s stay 5.59
  • Deprivation of liberty for serious medical treatment: NHS Trust v FG  5.61
  • Admission to an intensive care unit: R (Ferreira) v HM Senior Coroner for Inner South London 5.67
  • Ferreira in the Court of Appeal 5.68
  • Children and deprivation of liberty  5.70
  • Children under 16  5.70
  • Minors of 16–17 years  5.72
  • Pointers for practitioners considering unclear cases 5.74
  • Is there a deprivation of liberty? 5.74
  • Contingency declarations  5.79
  • D Authorising a deprivation of liberty 5.80
  • Procedure 5.84
  • MCA/Inherent jurisdiction?  5.85
  • Review  5.86
  • DOLS authorisation  5.88
  • Is the patient ineligible to be detained under the MCA? 5.93
  • E The Mental Capacity (Amendment) Act 2019 5.105
  • Section 4B – Life-sustaining treatment or vital act 5.106
  • Schedule AA1 – the LPS regime 5.107
  • F Practical issues 5.115
  • G Conclusion 5.120
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