FD24F00084 - [2025] EWHC 920 (Fam)

There is no obligation on a patient with decision-making capacity to accept life-saving treatment, and doctors are neither entitled nor obliged to give it. As set out by Lord Brandon in Re F (Mental Patient: Sterilisation) [1990] 2 AC 1: “a doctor cannot lawfully operate on adult patients of sound mind, or give them any other treatment involving the application of physical force ... without their consent’, and if he were to do so, he would commit the tort of trespass to the person”.

As Lord Goff observed in Airedale NHS Trust v Bland [1993] AC 789 at page 864:

“... the principle of self-determination requires that respect must be given to the wishes of the patient, so that if an adult patient of sound mind refuses, however unreasonably, to consent to treatment or care by which his life would or might be prolonged, the doctors responsible for his care must give effect to his wishes, even though they do not consider it to be in his best interests to do so”.

The right to self-determination was expressed succinctly by Judge LJ in St George's Healthcare NHS Trust v S [1999] (Fam) 26 at page 43G that:

“Even when his or her own life depends on receiving medical treatment, an adult of sound mind is entitled to refuse it”.

This right applies equally to detained citizens. In Home Secretary v Robb [1995] 1 FLR 412 Thorpe J (as he then was) explained that:

“… every person's body is inviolate and proof against any form of physical molestation …. The right of the defendant to determine his future is plain. That right is not diminished by his status as a detained prisoner”.