England and Wales Case Law

A (Covert Medication: Residence), Re

It is in A’s best interests to return home to her mother’s care, for covert medication to cease, and for A to be informed that she has been covertly administered HRT and that it has benefited her health. The continued deprivation of A’s liberty, covert medication, and separation from her mother are not justified by the remaining medical benefits of HRT, given the risks, infringements of autonomy, and the likelihood that covert medication cannot be sustained. The best interests assessment requires a less restrictive approach, prioritising A’s wishes, family life, and autonomy, with protective…

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• Best interests
• Covert medication
• Deprivation of liberty
• Residence
• Medical treatment
• Autonomy

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A (Covert Medication: Residence), Re

The judge was entitled to conclude, after a lengthy and finely balanced process, that the continuation of covert medication and deprivation of A's liberty were no longer justified by the remaining medical benefits, given the significant infringement of A's autonomy and rights, the lack of progress over five years, and the unlikelihood of A ever consenting to HRT. The judge's decision to return A home, cease covert medication, and inform her of the covert treatment was within his discretion and supported by coherent reasoning, despite professional opposition. The process, though not ideal, was…

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• Best interests decision
• Covert medication
• Deprivation of liberty
• Article 8 echr
• Article 2 and 3 echr
• Medical treatment without consent

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H (An Adult; Termination), Re

Ms H lacks capacity to decide on termination of her pregnancy due to Schizoaffective disorder and delusional beliefs. It is in her best interests to undergo a medical termination, as this aligns with her consistently expressed wishes, is supported by her treating clinicians and litigation friend, and presents less risk of psychological harm than a surgical termination. Covert medication is authorised, and restraint is authorised only in the limited circumstance of a necessary vaginal examination for safety after commencement of medical termination.

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• Termination of pregnancy
• Best interests
• Capacity to consent
• Use of restraint
• Covert medication

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A, Re (Covert Medication: Residence)

A, Re (Covert Medication: Residence) [2024] EWCA Civ 572 (23 May 2024)

The Court of Appeal upheld a Court of Protection decision that A should return home, covert medication should cease, and A should be told about it.

• Best interests decision
• Covert medication
• Residence
• Medical treatment
• Deprivation of liberty
• Article 8 echr

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A, Re (Covert Medication: Residence)

A, Re (Covert Medication: Residence) [2024] EWCOP 19 (20 March 2024)

The Court of Protection refused a mother's application for her daughter to return home, pending further review, and authorised continued covert HRT at the care home.

• Best interests decision-making
• Covert medication
• Residence of incapacitated adult
• Deprivation of liberty
• Medical treatment without consent
• Court-of-protection

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H, Re (An Adult; Termination)

H, Re (An Adult; Termination) [2023] EWCOP 183 (24 October 2023)

Court of Protection case on an incapacitated pregnant woman’s termination decision. The court found she lacked capacity and authorised a medical termination in her best interests.

• Termination of pregnancy
• Capacity assessment
• Best interests
• Use of restraint
• Covert medication
• Termination-of-pregnancy

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Re A (Covert Medication: Closed Proceedings)

The Court of Protection held that A should continue receiving covert hormone treatment for now, but the closed process must end and B must be told.

• Covert medication
• Best interests
• Closed proceedings
• Reporting restrictions
• Article 8 echr
• Article 10 echr

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A (Covert Medication: Closed Proceedings)

A (Covert Medication: Closed Proceedings) [2022] EWCOP 44 (07 October 2022)

Court of Protection case on covert hormone treatment for a woman lacking capacity. The court upheld continued treatment, required disclosure to her mother, and lifted closed proceedings.

• Covert medication
• Best interests
• Reporting restrictions
• Capacity assessment
• Article 8 echr
• Closed proceedings

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An NHS Trust v XB & Ors

An NHS Trust v XB & Ors [2020] EWCOP 71 (21 December 2020)

The Court of Protection declared that XB lacked capacity to consent to antihypertensive medication and approved covert administration under the care plan.

• Covert medication
• Best interests
• Capacity to consent
• Article 8 echr
• Delay in court applications
• Covert-medication

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An NHS Trust v XB & Ors

The Court of Protection held that XB lacked capacity to consent to antihypertensive medication and approved covert administration because untreated hypertension posed a serious risk to his life.

• Covert medication
• Best interests
• Capacity to consent
• Article 8 echr
• Delay in court application
• Covert-medication

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