In the Matter Of E.R (Mental Health and Guardianship and Management of Property)

The matter before the Administrative Appeals Tribunal (AAT) involved a dispute over the capacity of E.R., a person with dual disability, to consent to psychiatric treatment. The primary legal issue was whether E.R. had the requisite capacity to provide lawful consent to ongoing psychiatric treatment, specifically medication, within the context of her living arrangements in a structured environment. The dispute hinged on the interpretation of the Mental Health Act and the Human Rights Act, particularly focusing on the fluctuating nature of capacity and the necessity for supported decision-making.

The AAT examined the evidence provided by various expert witnesses and concluded that the capacity to consent to psychiatric treatment must be assessed in relation to specific decisions rather than generally. The Tribunal found that Dr. Wurth and Dr. Kasinathan's assessments, which considered E.R.'s capacity to consent to specific treatments, were more relevant and reliable compared to Dr. Thompson's assessment, which evaluated capacity in a more general sense. The AAT emphasised that capacity should be evaluated in the context of the specific treatment decision and that it could fluctuate over time. The Tribunal also highlighted that supported decision-making did not negate a person's capacity to consent.

Ultimately, the AAT determined that E.R.'s acquiescence to psychiatric treatment, while occurring within a controlled environment, did not necessarily equate to involuntary consent. The Tribunal acknowledged that E.R.'s reliance on staff for medication administration did not preclude her from having the capacity to consent voluntarily. The AAT concluded that E.R. had the capacity to consent to psychiatric treatment, provided that the necessary support was given to facilitate her understanding and decision-making process.