Thursday 24 August 2017

Mentally-ill pensioner 'should not face enforced amputation'

Judge's gavel
Judge's gavel

Brian Farmer

A diabetic, mentally-ill pensioner should not be forced to have his severely-infected left foot amputated even though he could die within days without surgery, a judge has ruled.

Mr Justice Peter Jackson has concluded that "enforced amputation" would not be in the 73-year-old man's best interests after analysing the case at a hearing in the Court of Protection, in London, where issues relating to sick and vulnerable people are considered.

The pensioner - who had suffered mental illness for decades, had no next of kin and was "isolated" - might live for a few years if his foot was amputated, the judge said.

He had opposed surgery in "the strongest possible terms" and said: "I'm not afraid of dying ... It would be a better life than this."

Mr Justice Jackson concluded that the pensioner did not have the mental capacity to make decisions about treatment.

But the judge said it would not be in the pensioner's best interests to "take away his little remaining independence and dignity" in order to replace it with a future for which he "understandably" had "no appetite".

The judge made his decision after visiting the unit where the man was being cared for and speaking to him for more than an hour.

Bosses at a health trust had asked the judge to allow doctors to amputate the pensioner's left leg below the knee against his will in order to save his life.

The pensioner's interests had been protected by a lawyer representing the Official Solicitor's office - an official body which gives legal help to vulnerable people - who supported the trust's plan.

Mr Justice Jackson was told that the pensioner had developed paranoid schizophrenia in his mid-20s and heard "voices of angels and of the Virgin Mary".

He had also suffered from diabetes for some years and last year had developed a chronic foot ulcer that had not healed despite doctors' efforts. Amputation had been discussed for about a year. His foot was "putrefying" but he was refusing all treatment - only allowing dressings to be changed. A specialist had said the pensioner could "succumb" within days to "overwhelming infection".

The judge said neither the pensioner nor the unit where he was being cared for could be identified.

But he said the trust which had asked for a declaration that amputation would be lawful could be named as the Wye Valley NHS Trust - which is based in Hereford.

He said the trust's application had been "rightly brought" - even though it was dismissed.

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