Re C (Adult: Refusal of Treatment) [1994] 1 WLR 290. In this English case, C was a 68 year old man with schizophrenia who was a long-term resident of what is now known as the Broadmoor Hospital. C developed gangrene of the foot and surgeons recommended a below knee amputation. C refused amputation on the basis he would rather die with two legs than live with one. C had a delusion that he was an internationally famous doctor. Despite this, Thorpe J found C competent to refuse treatment on the basis that he could comprehend and retain relevant information, believe it, and weigh it in the balance to arrive at a choice. Thorpe J found that the delusions did not impact on C’s ability to perform these tasks. Re MB [1997] 2 FCR 541. MB had consented to an emergency caesarean section, but she suffered needle phobia and resisted the administration of anaesthetics. Anaesthesia by mask was attempted but was unsuccessful. Further attempts to use a needle failed, even though MB continued to consent to the procedure. Doctors sought an order to permit them to forcibly provide the anaesthetic. The Court of Appeal of England and Wales found that MB’s phobia meant that she was “incapable of making a decision at all” and treatment was approved. Brightwater Care Group Inc v Rossiter [2009] WASC 229. In this Australian case, Rossiter was a quadriplegic who was dependent on artificial feeding and hydration through a feeding tube (PEG). Rossiter expressed a desire to refuse feeding and die. He gave numerous directions to carers to cease feeding and hydration. The Supreme Court of Western Australia found that it would be lawful to withdraw treatment as Rossiter’s capacity was attested to by several experts including a clinical neuropsychologist. Auckland Area Health Board v Attorney-General [1993] 1 NZLR 235. A patient with Guillain-Barre Syndrome (a condition which impairs communication through progressive paralysis but does not impair cognition) was presumed to be incompetent by the court seemingly because of his inability to communicate Fitzpatrick v K [2008] IEHC 104. An African woman living in Ireland haemorrhaged after giving birth. After emergency treatment had commenced the staff were told by the patient that she was a Jehovah’s Witness and that she refused blood (on admission she had claimed to be a Roman Catholic). The patient suggested that she should be given Coca-Cola, tomatoes, eggs, and milk as an alternative to blood products. The treating obstetrician doubted the patient’s capacity to make a decision and approached the court for a determination on capacity and for an order authorizing treatment in the interim. These orders were made. The woman later appealed the decision. The court found that, while the patient may have been competent to refuse treatment, at the time there was sufficient uncertainty with regards to the patient’s ability to retain and understand information to justify the court order.