Health - 1993

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This page lists 15 cases, and was prepared on 28 October 2012.

Regina -v- Ealing District Health Authority, ex parte Fox [1993] 1 WLR 373
1993 Otton J	Health	Casemap 1 Citers
	A patient's conditional discharge had been ordered by a tribunal. One of the conditions imposed by the tribunal was the appointment by the health authority of a responsible medical officer to provide psychiatric supervision of the patient in the community. The authority refused to make the appointment. Held: "I reject the submission that this duty (under section 117) only comes into existence when the applicant is discharged from Broadmoor. I consider a proper interpretation of this section to be that it is a continuing duty in respect of any patient who may be discharged and falls within section 117, although the duty to any particular patient is only triggered at the moment of discharge." The court declared "(1) that the authority has erred in law in not attempting with all reasonable expedition and diligence to make arrangements so as to enable the applicant to comply with the conditions imposed by the mental health review tribunal; (2) that a district health authority is under a duty under section 117 of the Mental Health Act 1983 to provide aftercare services when patient leaves hospital, and acts unlawfully in failing to seek to make practical arrangements for after-care prior to that patient's discharge from hospital where such arrangements are required by mental health review tribunal in order to enable the patient to be conditionally discharged from hospital."
	Mental Health Act 1983 117

Re T (An Adult) (Consent to Medical Treatment) [1993] Fam 95
1993 CA Donaldson MR	Health	Casemap 1 Citers
	The patient who was pregnant had been involved in a car accident and during hospital treatment required a blood transfusion. Held: "Doctors faced with a refusal of consent have to give very careful and detailed consideration to the patient´s capacity to decide at the time when the decision was made. It may not be the simple case of the patient having no capacity because, for example, at that time he had hallucinations. It may be the more difficult case of a temporarily reduced capacity at the time when his decision was made. What matters is that the doctors should consider whether at that time he had a capacity which was commensurate with the gravity of the decision which he purported to make. The more serious the decision, the greater the capacity required. If the patient had the requisite capacity, they are bound by his decision. If not, they are free to treat him in what they believe to be his best interests."

Airedale NHS Trust -v- Bland [1993] AC 789; [1993] 2 WLR 316; [1992] UKHL 5
4 Feb 1993 HL Lord Keith of Kinkel, Lord Goff of Chieveley, Lord Lowry, Lord Browne-Wilkinson and Lord Mustill	Health, Health Professions, Administrative, Crime	Casemap 1 Cites 1 Citers
	The patient had been severely injured in the Hillsborough disaster, and had come to be in a persistent vegetative state (PVS). The doctors sought permission to withdraw medical treatment. The Official Solicitor appealed against an order of the Court of Appeal permitting the action. Held: The appeal failed. The practitioners sought to act in accordance with medical practice, but until the practice was universally accepted, applications should continue to be made to the Family Division. The issues should be considered urgently by Parliament. Any justification for invasive treatment no longer existed, and the doctors were correct to seek to discontinue treatment. The patient could himself no longer choose. It would not be unlawful to cease to provide the treatment which it had previously been a duty to perform. Lord Goff said: "I must however stress, at this point, that the law draws a crucial distinction between cases in which a doctor decides not to provide, or to continue to provide, for his patient treatment or care which could or might prolong his life, and those in which he decides, for example by administering a lethal drug, actively to bring his patient's life to an end. As I have already indicated, the former may be lawful, either because the doctor is giving effect to his patient's wishes by withholding treatment or care, or even in certain circumstances in which (on principles which I shall describe) the patient is incapacitated from stating whether or not he gives his consent. But it is not lawful for a doctor to administer a drug to his patient to bring about his death, even though that course is prompted by a humanitarian desire to end his suffering, however great that suffering may be: see Reg v Cox (unreported), 18 September 1992. So to act is to cross the Rubicon which runs between on the one hand the care of the living patient and on the other hand euthanasia - actively causing his death to avoid or to end his suffering. Euthanasia is not lawful at common law. It is of course well known that there are many responsible members of our society who believe that euthanasia should be made lawful; but that result could, I believe only be achieved by legislation which expresses the democratic will that so fundamental a change should be made in our law, and can, if enacted, ensure that such legalised killing can only be carried out subject to appropriate supervision and control. It is true that the drawing of this distinction may lead to a charge of hypocrisy; because it can be asked why, if the doctor, by discontinuing treatment, is entitled in consequence to let his patient die, it should not be lawful to put him out of his misery straight away, in a more humane manner, by lethal injection, rather than let him linger on in pain until he dies. But the law does not feel able to authorise euthanasia, even in circumstances such as these; for once euthanasia is recognised as lawful in these circumstances, it is difficult to see any logical basis for excluding it in others. "
	Link[s] omitted

Regina -v- Managers of South Western Hospital and Another, Ex Parte M [1993] QB 683; [1994] 1 All ER 161; [1993] 3 WLR 376
24 Mar 1993 QBD Laws J	Health, Torts - Other	Casemap 1 Citers
	The patient was detained on the application of an AMHP. In purported pursuance of section 11(4) the AMHP had consulted the patient's mother as her nearest relative. However, the patient's mother was not ordinarily resident in the UK, and, according to the statutory definition of "nearest relative", the AMHP ought to have consulted the patient's uncle. He was in fact consulted, but not in the capacity of nearest relative. Neither the patient's mother nor the patient's uncle objected to her admission. Held: The AMHP had unwittingly acted outside the Act. An application for the renewed detention of a patient under section 3 was proper despite a recent tribunal ruling that the patient should be released. The social worker had a duty under the Act to admit a patient in this way when the circumstances of the Act applied. The application should have been made by way of judicial review rather than under habeas corpus. 'there is no sense in which those concerned in a section 3 application are at any stage bound by an earlier tribunal decision.'
	Mental Health Act 1983 2 3 4 6 11 13

Regina -v- Secretary of State for the Home Department, Ex Parte Didlick
30 Mar 1993 QBD	Health
	A restriction did not expire simply by being allowed to elapse, but could only be brought to an end by a direction from the Home Secretary or by the patient being discharged from the hospital.
	Mental Health Act 1959 - Mental Health Act 1983

Regina -v- Secretary of State for Home Department ex parte Didlick
9 Apr 1993 QBD	Health
	A Mentall Health Act order restricting a patient's discharge remains in force till the Home Secretary directs otherwise.
	Mental Health Act 1983 42-3

Re O (A minor) (Medical Treatment) [1993] 2 FLR 149
12 Apr 1993 FD Johnson J	Children, Health, Ecclesiastical	Casemap
	The local authority applied for a care order in relation to the child, on the ground that there was an urgent and continuing need for medical treatment which included blood transfusions. The court considered the legal effect of a parent's belief (as Jehovah's Witesses) that medical treatment by blood transfusion is forbidden by the Bible and is sinful, even if it is the only means of saving life. Held: Wardship was refused. Johhnson J rejected the "specific issue" route on the ground that the trial of an "issue" arguably required the preliminary step of giving directions, and that in an emergency, an issue could not be determined on an ex parte basis. Johnson J said: "Counsel submitted that it was wholly inappropriate for the court to make even an interim care order where the child's parents were caring, committed and capable and only this one issue arose for decision, albeit one of the gravest significance. Reflecting on the statutory provisions, and in particular section 33 (of the Children Act 1989), I accept that joint submission."
	Children Act 1989 33

Regina -v- Kirklees Borough Council ex parte C (A Minor) [1993] FLR 187
12 Apr 1993 CA Lloyd LJ	Local Government, Children, Health	1 Citers
	A Local Authority may admit a minor in care to a mental hospital for assessment or treatment. Section 131 merely preserves or confirms the common law and previous law. Consent requires proof of conduct and a reasoning capacity.
	Mental Health Act 1983 131

Camden London Borough Council -v- R (A Minor) (Blood Transfusion); in Re R (A Minor)(Blood Transfusion) [1993] 2 FLR 757
8 Jun 1993 FD Booth J	Children, Health	Casemap 1 Cites 1 Citers
	Child A's doctors considered that she would need treatment over the following two years and that this could involve the need for blood transfusions at any time. The parents were Jehovah's Witnesses and refused consent. Held: The order allowing a transfusion to be given was made. The child's need for blood was so overwhelming that, in her best interests, her parent's beliefs had to be overridden. An authority should obtain a specific issue order with regard to the use of blood products on a child. Booth J discussed the issue of how such applications should be handled procedurally: "I am in complete agreement with the essential premise of the conclusions reached by Johnson J. Such issues are of the utmost gravity and are of particular anxiety since the decision of the court may run counter to the most profound and sincerely held beliefs of the parents. For these reasons the most strenuous efforts should always be made to achieve an inter partes hearing. Such issues should also be determined, wherever possible, by a High Court judge and this is of particular importance in those exceptional circumstances where an application must be made ex parte so that the parents cannot be heard. But in my judgment these prerequisites can be as well met by an application for a specific issue order under s 8 as by an application for the exercise of the court's inherent jurisdiction. A section 8 application can, and in circumstances such as these undoubtedly should, be made to the High Court. When leave to make it is sought by a local authority, or other appropriate body or person, the district judge, as in this case, can give all necessary directions for a speedy hearing. It will then be heard by a High Court judge. Although there is yet no reported decision as to whether or not a specific issue order can be made ex parte, I should be very surprised if the words of the statute had to be interpreted so narrowly as to deny the court power to give such relief where it was otherwise justified and the circumstances compelled an ex parte hearing. But if such an issue were to come before a judge of the Family Division who was constrained to find the court's jurisdiction to be so limited, the power to invoke the exercise of the inherent jurisdiction of the court would be immediately available and appropriate. In the present case I am in no doubt that the application is well-founded under section 8 of the Act. The result which the local authority wishes to achieve, namely, the court's authorisation for the use of blood products, can clearly be achieved by the means of such an order. There is no need for the court otherwise to intervene to safeguard the little girl, so that I am satisfied that it is unnecessary and inappropriate for the court to exercise its inherent jurisdiction."
	Children Act 1989 8

Regina -v- Secretary of State for Health, ex parte Gallaher and others (Judgment) C-11/92; [1993] EUECJ C-11/92
22 Jun 1993 ECJ	European, Health, Media	1 Citers
	Member States may decide size of government health warnings on cigarettes Europa Articles 3(3) and 4(4) of Directive 89/622 on the labelling of tobacco products provide respectively that the indications of tar and nicotine yields and the general and specific health warnings that cigarette packets must carry shall cover at least 4% of the surfaces for which they are intended. Those provisions must be interpreted as meaning that, if they consider it to be necessary, Member States are at liberty to decide, so far as domestic production is concerned, that those indications and warnings should cover a greater surface area in view of the level of public awareness of the health risks associated with tobacco consumption. In so far as those Member States cannot make subject to the same requirement products imported from the other Member States which comply with the minimum requirements of the directive, there is a risk of less favourable treatment for national products and of inequality in conditions of competition, although this is inherent in harmonization which confines itself to laying down minimum requirements.
	Link[s] omitted

Practice Note (Official Solicitor: Sterilisation)
22 Jun 1993 FD	Litigation Practice, Children, Health
	Practice Note by Official Solicitor setting out the procedure to be followed when considering the sterilisation of a Minor.

Regina -v- Cannons Park Mental Health Review Tribunal, Ex Parte A
24 Aug 1993 QBD	Health, Human Rights	Casemap 1 Citers
	It was unlawful to detain a psychopath for treatment where in fact his condition was untreatable.
	Mental Health Act 1983 3(2)

Regina -v- Newcastle Upon Tyne City Council ex parte Dixon
21 Oct 1993 QBD	Health, Local Government
	Council may impose additional clauses with economic requirements, on Registered Nursing Homes in contracts for care provision.

Birmingham Post and Mail Ltd -v- Birmingham City Council
12 Nov 1993 QBD	Health, Litigation Practice	Casemap 1 Citers
	The name of a person with a notifiable disease could be withheld pending an appeal, but any anonymity given by court to party must end when it would not be needed for the purposes of justice. The power to make an order under s.11 must be exercised carefully and cannot be used simply to protect privacy or avoid embarrassment An open ended order was inappropriate.
	Public Health (Control of Diseases) Act 1984 37 - Contempt of Court Act 1981 11

Regina -v- Trent Regional Authority, ex parte Somaratne
10 Dec 1993 QBD	Health
	Secretary of State for Health entitled to have regard to the fitness of doctor.
	Mental Health Act 1993 12-2