The High Court has recognised an imprisoned man’s decision to refuse food, medication and medical treatment, finding that he had capacity to make that choice and understood its potential consequences. The ruling does not require the prison to force-feed or treat him against his expressed wishes.
Mr Justice Paul Burns delivered the judgment on 11 January 2023, after an expedited hearing on 4 January. The defendant consented to the declarations sought by the Governor of X Prison, and no party argued against the governor’s submissions. Interim relief had been granted on 31 December 2022.
The defendant, about 72, was serving a 14-year-and-two-month sentence imposed after he pleaded guilty to ten indecent assault counts. He was also due to face trial on further charges on 16 January 2023. The judgment anonymises him and the prison, citing the need to avoid prejudicing that trial and to protect its integrity.
The defendant had resumed refusing food and diabetes medication on 30 December 2022, while continuing to drink liquids. He had also refused resuscitation and hospital treatment, but said he would accept pain relief, coma-inducing medication and end-of-life treatment. He told the court his refusal arose from grievances including his concern that he would not receive a fair trial and a broader sense of being treated unfairly.
Two psychiatrists who examined him in early January found no mental illness impairing his decision-making capacity. The court heard that his capacity could change and required ongoing assessment. The judge said the evidence established that the defendant had full capacity and understood the ultimate consequences of refusing food and medical treatment. The governor gave evidence that prison policy prohibited force-feeding a prisoner with capacity who refused nourishment, and that the defendant was under medical supervision.
The court granted the declarations sought, with a change to one: the defendant could be transferred from prison to hospital for palliative or end-of-life care, provided his wishes about treatment were respected. The ruling recognised that his capacity and wishes should continue to be monitored and assessed as circumstances changed.
The court also imposed a reporting restriction covering the defendant’s name and anything that could identify him, including the prison’s name. The judge urged him to reconsider his decision to refuse food and medication. The judgment said it was not then known whether he had done so.