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Sophia Roper instructed by the OS in Cheshire & Wirral NHS Trust v Z

30th January 2017

Sophia was instructed by the Official Solicitor on behalf of a woman with chronic and severe anorexia (‘Z’), on an application by the Cheshire & Wirral Partnership NHS Foundation Trust. Z had suffered from anorexia since she was 15, and was now in her 40s. Many different treatments, including specialist residential treatment, had failed, and she had never been able to engage in the therapy required to treat her underlying condition. Her BMI at the time of the application was 9.3 or lower. She was detained under s3 Mental Health Act 1983 in hospital, but had ceased to engage with her care plan as an inpatient.

The Trust proposed three alternative options: forcibly feeding Z by restraint, doing the same by sedation, or discharging her from hospital and allowing her to return to live with her parents, and receive treatment only as and when she wished. The first two options were fraught with physical risk, because of Z’s frail condition; both the Trust and the instructed expert, Dr Glover, also considered forcible feeding by either route to be inhumane, because of the acute distress it would cause to Z. Z was known to do better at least emotionally when she was left to herself and not given compulsory or coercive treatment. The Trust therefore wished to discharge Z from detention and to implement this third option.

Hayden J agreed and approved the proposed care plan, saying that this was ‘the only proposal which carries any vestige of hope and most effectively preserves Z’s dignity and autonomy.’

You can read the judgment here.

You can read commentary on this case on Alex Ruck Keene’s blog here.

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