In 2015, a much-publicised case was decided by the Court of Protection. It was both tragically sad and the stuff of fables.
The 50-year-old woman at the centre of this case, named only as ‘C’ in the anonymised judgment, was, in effect, granted the right to die by the Court of Protection.
Mr Justice MacDonald found that C did have the capacity to make decisions regarding her medical treatment, and her autonomy should thus be respected in her right to refuse medical treatment, even if that treatment would save her life.
C was diagnosed with breast cancer last year when on the cusp of turning 50. According to the judgment, she accepted news of her diagnosis strangely well, saying that she was “actually kind of glad because the timing was right".
The judge noted C’s idiosyncrasies in detail. He wrote:
C is a person to whom the epithet ‘conventional’ will never be applied. By her own account, the account of her eldest daughters and the account of her father, C has led a life characterised by impulsive and self-centred decision making without guilt or regret. C has had four marriages and a number of affairs and has, it is said, spent the money of her husbands and lovers recklessly before moving on when things got difficult or the money ran out. She has, by their account, been an entirely reluctant and at times completely indifferent mother to her three caring daughters. Her consumption of alcohol has been excessive and, at times, out of control. C is, as all who know her and C herself appears to agree, a person who seeks to live life entirely, and unapologetically on her own terms; that life revolving largely around her looks, men, material possessions and ‘living the high life’. In particular, it is clear that during her life C has placed a significant premium on youth and beauty and on living a life that, in C’s words, ‘sparkles’.
After her cancer diagnosis and the acrimonious breakdown of a long-term relationship, C became stressed. In September 2015 she made a ’premeditated and planned’ suicide attempt by overdose. She did not succeed in killing herself, but the suicide bid caused her to suffer an injury to her liver and an acute injury to her kidneys. This led to her needing a course of dialysis treatment which would likely save her life. But C refused further dialysis treatment.
Mr Justice MacDonald determined that she had capacity to make this decision, reminding the court that “a capacitous patient may refuse treatment even in circumstances where that refusal will lead to his or her death". A person who has capacity is entitled to make decisions that would be bad for them.
Mr Justice MacDonald also said: “Despite her patent faults C is dear to her daughters. V relates that she and G have learnt to accept their mother for who she is: complexities, seeming contradictions, blind spots, self-centred and manipulative behaviour, excruciating honesty and all". One of C’s daughters, identified as V in the judgment, is quoted thus:
My mother’s values, and the choices that she made have always been based on looks (hers and other people’s), money, and living (at all costs) what she called her ’sparkly’ lifestyle… her life was, from her point of view, a life well lived. I have never known her express regret, or really to take responsibility for anything, including the choices she has made.
Zoe Williams asserted in an article in the Guardian that the judgments contained within the judgement worked to reinforce stereotypes about femininity and ’what is expected of women’. She asks whether a man who had been through multiple marriages and been rather profligate would be deemed to have quite as many character defects as C.
On the 3rd December 2015, C’s lawyers revealed that she had died.
The judgment can be read in full here.