Deprivation of Liberty – Part 3

3 Nov

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DOLS – Part 3

 

Following the case of Cheshire West by the Supreme Court in respect of Deprivation of Liberty there were a number of other cases.  The key phrase from Cheshire West was whether someone was under “continuous control and supervision”.

 

The case of Ferreria is a sad one, as it was a Coroner’s case following the death of Maria.  The issue was whether she had been deprived of her liberty when she was in hospital during the last few days / weeks of her life.

 

The details of the case are:

Maria 45, at the time of her death.  She had down syndrome, a severe learning disability and limited mobility.  She was living with her sister and required 24 hour care.  She was admitted to hospital with a diagnosis of: Pericarditis, pneumonia and possible pulmonary oedema, which was not directly related to her disability.  She had a strong dislike of hospitals and found the procedures frightening.  Her sister advocated for discharge due to her anxiety but consultant said “we have not really completed all the investigations we would have done if we had a patient who found investigations easier to tolerate”!!  At this point I would raise the issue of that much fated phrase “person centred care”!  Why did the need to follow the process have such a status when considered against the known wishes of someone to be discharged as soon as possible, as Marie found being there so distressing and frightening!

 

Eventually Maria’s condition worsened and she was ventilated.  She had mittens put on her to stop her reaching for the endotracheal tube (normal procedure) & later knocked out the tube as she was only wearing one mitten (there was a shortage of mittens), which was quickly noticed, attempts at resuscitation were made, she went into cardiac arrest and died.

 

Maria was clearly detained / restrained as she had a life threatening condition.  In particular, once she was ventilated, she would die quickly if she was not treated, which meant that she needed to be restrained for that to happen.  This had nothing to do with her condition and was normal practise for anyone who is ventilated, regardless of whether they are cognitively impaired or not.  It is still arguable that she is under “continuous control and supervision”.

 

The Coroner’s inquest was held and the Administrative Court decided that Maria was treated in her “best interests” and this didn’t mean that she was deprived of her liberty, as her treatment didn’t relate to her underlying disability.

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