Q: Can a Court or Patient Demand Treatment? A: Yeah But No

The principle from Re J [1993] 3 WLR 507 has stood since 1993: a mentally competent patient cannot demand a specific treatment, nor can a court make an order which would force a doctor to administer a treatment, which, in either case, the responsible doctor considers is contrary to his/her best interests. This column considers the extent to which this principle remains good law 25 years later, concluding that it retains most current relevance in respect of mentally competent patients. In respect of mentally incapacitated patients, however, once a court's jurisdiction has been invoked, the principle appears to be observed in form only, rather than in substance. We have moved a long way from doctors having the ultimate power and responsibility for making treatment decisions to courts becoming heavily involved in making them.