QKQ - [2022] NSWCATGD 11

NSW Civil and Administrative Tribunal

New South Wales

Medium Neutral Citation: QKQ [2022] NSWCATGD 11
Hearing dates: 3 March 2022
Date of orders: 3 March 2022
Decision date: 03 March 2022
Jurisdiction: Guardianship Division
Before: R H Booby, Senior Member (Legal)
Dr B McPhee, Senior Member (Professional)
F N Given, General Member (Community)
Decision:
The Tribunal consents to the following special medical treatment being provided to QKQ:
Androcur (Cyproterone Acetate) up to 400 mg daily and any necessary treatment that would normally be provided in association with or directly consequent upon the above treatment.
This consent is effective for a period of three month(s) from the date of this order.
Public Guardian, the appointed guardian for QKQ, is given the authority to consent to continuation of Androcur (Cyproterone Acetate) up to 400 mg daily.
The guardianship order for QKQ made on 27 March 2019 has been reviewed. The order now is as follows:
1. The Public Guardian is appointed as the guardian.
2. This is a continuing guardianship order for a period of three years from 3 March 2022.
3. This is a limited guardianship order giving the guardian(s) custody of QKQ to the extent necessary to carry out the functions below.
FUNCTIONS:
4. The guardian has the following functions:
a) Accommodation
To decide where QKQ may reside.
b) Health care
To decide what health care QKQ may receive.
c) Medical/Dental consent
To make substitute decisions about proposed minor or major medical or dental treatment, where QKQ is not capable of giving a valid consent.
d) Services
To make decisions about services to be provided to QKQ.
e) Restrictive Practices
To give or withhold consent as to whether the following restrictive practices should be used to influence QKQ’s behaviour:
1. Chemical restraint;
2. Environmental restraint.
AUTHORITY
5. The guardian has the following authority:
a) Authority to consent to continuation of special treatment
i) The guardian may consent to the continuation of the special treatment which the Tribunal consented to on 3 March 2022. That special treatment is:
Administration of Androcur (Cyproterone Acetate) up to 400 mg per day
CONDITIONS:
6. The conditions of this order are:
a) Standard Condition
In exercising this role the guardian shall take all reasonable steps to bring QKQ to an understanding of the issues and to obtain and consider his views before making significant decisions.
b) Restrictive Practices Condition
The guardian(s) may only consent to the use of the types of restrictive practices permitted under this order to influence QKQ’s behaviour:
(i) as a last resort to prevent QKQ harming himself or others; and
(ii) in accordance with a behaviour support plan which has been developed by a behaviour support practitioner after having conducted a functional behavioural assessment upon QKQ, and which is reviewed regularly (and no less than every 12 months) and/or reviewed as soon as practicable if there is a change in circumstances which requires the plan to be amended.

Catchwords:
CONSENT TO MEDICAL TREATMENT – application for consent to special medical treatment…

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

Continue reading QKQ

Details

AGLC: QKQ [2022] NSWCATGD 11
Case: [2022] NSWCATGD 11
Decision Date: 03 March 2022

CaseChat Overview and Summary

This case involved an application for consent to special medical treatment for QKQ, a person who is not capable of providing informed consent due to their intellectual disability and history of sexually inappropriate behaviour. The application was for anti-androgen medication, Androcur (Cyproterone Acetate), to modify the subject person's behaviour. The Public Guardian was also seeking an end-of-term review of the guardianship order for QKQ, which had been in place since 27 March 2019. The legal issues before the court included whether the special medical treatment proposed was appropriate, and whether a further guardianship order should be made.

The court found that the proposed treatment was the most appropriate form of treatment to promote QKQ's health and well-being, and granted consent for the administration of Androcur up to 400 mg daily for a limited period of three months. The court also found that a further guardianship order should be made, appointing the Public Guardian as the guardian for QKQ. The order includes functions such as deciding on accommodation, health care, and medical/dental consent, as well as authority to consent to continuation of special treatment, including the administration of Androcur. The order also includes conditions that the guardian must take all reasonable steps to involve QKQ in decision-making, and that restrictive practices such as chemical and environmental restraint can only be used under certain circumstances.

The final orders of the court include consent for the administration of Androcur up to 400 mg daily for three months, reappointment of the Public Guardian as the guardian for QKQ, and a new guardianship order with specified functions and authority. The order also includes conditions that the guardian must follow when making decisions on behalf of QKQ. These orders provide clarity and guidance for the guardian and medical professionals involved in QKQ's care, ensuring that the subject person receives appropriate treatment and support.

Orders

Orders of the court

The Tribunal consents to the following special medical treatment being provided to QKQ:

Androcur (Cyproterone Acetate) up to 400 mg daily and any necessary treatment that would normally be provided in association with or directly consequent upon the above treatment.

This consent is effective for a period of three month(s) from the date of this order.

Public Guardian, the appointed guardian for QKQ, is given the authority to consent to continuation of Androcur (Cyproterone Acetate) up to 400 mg daily.

The guardianship order for QKQ made on 27 March 2019 has been reviewed. The order now is as follows:

1. The Public Guardian is appointed as the guardian.

2. This is a continuing guardianship order for a period of three years from 3 March 2022.

3. This is a limited guardianship order giving the guardian(s) custody of QKQ to the extent necessary to carry out the functions below.

FUNCTIONS:

4. The guardian has the following functions:

a) Accommodation

To decide where QKQ may reside.

b) Health care

To decide what health care QKQ may receive.

c) Medical/Dental consent

To make substitute decisions about proposed minor or major medical or dental treatment, where QKQ is not capable of giving a valid consent.

d) Services

To make decisions about services to be provided to QKQ.

e) Restrictive Practices

To give or withhold consent as to whether the following restrictive practices should be used to influence QKQ’s behaviour:

1. Chemical restraint;

2. Environmental restraint.

AUTHORITY

5. The guardian has the following authority:

a) Authority to consent to continuation of special treatment

i) The guardian may consent to the continuation of the special treatment which the Tribunal consented to on 3 March 2022. That special treatment is:

Administration of Androcur (Cyproterone Acetate) up to 400 mg per day

CONDITIONS:

6. The conditions of this order are:

a) Standard Condition

In exercising this role the guardian shall take all reasonable steps to bring QKQ to an understanding of the issues and to obtain and consider his views before making significant decisions.

b) Restrictive Practices Condition

The guardian(s) may only consent to the use of the types of restrictive practices permitted under this order to influence QKQ’s behaviour:

(i) as a last resort to prevent QKQ harming himself or others; and

(ii) in accordance with a behaviour support plan which has been developed by a behaviour support practitioner after having conducted a functional behavioural assessment upon QKQ, and which is reviewed regularly (and no less than every 12 months) and/or reviewed as soon as practicable if there is a change in circumstances which requires the plan to be amended.

Background

Background to the litigation

Full text does not contain this section.

Evidence

Evidence Before The Court

Full text does not contain this section.

Decision

Reasons for decision

Full text does not contain this section.

Ratio Decidendi

Legal Principle Established

Full text does not contain this section.

Medium Neutral Citation:	QKQ [2022] NSWCATGD 11
Hearing dates:	3 March 2022
Date of orders:	3 March 2022
Decision date:	03 March 2022
Jurisdiction:	Guardianship Division
Before:	R H Booby, Senior Member (Legal) Dr B McPhee, Senior Member (Professional) F N Given, General Member (Community)
Decision:	The Tribunal consents to the following special medical treatment being provided to QKQ: Androcur (Cyproterone Acetate) up to 400 mg daily and any necessary treatment that would normally be provided in association with or directly consequent upon the above treatment. This consent is effective for a period of three month(s) from the date of this order. Public Guardian, the appointed guardian for QKQ, is given the authority to consent to continuation of Androcur (Cyproterone Acetate) up to 400 mg daily. The guardianship order for QKQ made on 27 March 2019 has been reviewed. The order now is as follows: 1. The Public Guardian is appointed as the guardian. 2. This is a continuing guardianship order for a period of three years from 3 March 2022. 3. This is a limited guardianship order giving the guardian(s) custody of QKQ to the extent necessary to carry out the functions below. FUNCTIONS: 4. The guardian has the following functions: a) Accommodation To decide where QKQ may reside. b) Health care To decide what health care QKQ may receive. c) Medical/Dental consent To make substitute decisions about proposed minor or major medical or dental treatment, where QKQ is not capable of giving a valid consent. d) Services To make decisions about services to be provided to QKQ. e) Restrictive Practices To give or withhold consent as to whether the following restrictive practices should be used to influence QKQ’s behaviour: 1. Chemical restraint; 2. Environmental restraint. AUTHORITY 5. The guardian has the following authority: a) Authority to consent to continuation of special treatment i) The guardian may consent to the continuation of the special treatment which the Tribunal consented to on 3 March 2022. That special treatment is: Administration of Androcur (Cyproterone Acetate) up to 400 mg per day CONDITIONS: 6. The conditions of this order are: a) Standard Condition In exercising this role the guardian shall take all reasonable steps to bring QKQ to an understanding of the issues and to obtain and consider his views before making significant decisions. b) Restrictive Practices Condition The guardian(s) may only consent to the use of the types of restrictive practices permitted under this order to influence QKQ’s behaviour: (i) as a last resort to prevent QKQ harming himself or others; and (ii) in accordance with a behaviour support plan which has been developed by a behaviour support practitioner after having conducted a functional behavioural assessment upon QKQ, and which is reviewed regularly (and no less than every 12 months) and/or reviewed as soon as practicable if there is a change in circumstances which requires the plan to be amended.
Catchwords:	CONSENT TO MEDICAL TREATMENT – application for consent to special medical treatment…