This case involved GH who is a 52 year old woman with a diagnosis of schizoaffective disorder. GH was diagnosed with breast cancer in March 2023 however she does not believe the diagnosis and refuses all treatment.  

The problem was not that GH could not understand the key concepts involved, it was that she had delusional beliefs that prevented her from understanding that she has cancer and weighing this information up. 

Due to the refusal of treatment, the NHS Trust (who were responsible for managing her treatment) applied to the Court for declarations and orders that GH lacked capacity to conduct these proceedings. GH also was unable to make decisions on whether or not to undergo breast cancer surgery therefore the Trust applied that it was lawful and in her best interests for the Applicant to deliver care and treatment in accordance with her care plan. This involved sedation, anaesthesia and a right mastectomy. 

The Application was considered and discussed as long ago as May 2023. This raised concerns as it was made nearly seven months after diagnosis and so shortly before the listed surgery. 

Following the application, the Court made the declarations and concluded that it was in GH’s best interests to undergo the proposed surgery. The Trust was also ordered to pay 80% of the costs of the Official Solicitor because of the unreasonable delay in the Trust making the application. 

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