An autistic young man had all his healthy teeth removed on the orders of doctors, it was revealed yesterday.
The permanent operation left the man facing the rest of his life subsisting on liquids or forced to use dentures to chew solid food.
The decision to carry out the procedure and inflict a long-term disability was not tested in a court of law or approved by a judge, according to evidence provided by lawyers who work in the secretive and controversial Court of Protection.
Instead it was taken in secret by health workers who said it was necessary to stop the man from harming himself.
The harsh and radical dental operation was disclosed in files presented to a House of Lords committee investigating the Court and the law which gave birth to it, Labour’s 2005 Mental Capacity Act.
It follows the scandal last month over the decision of a Court of Protection judge to order a forced caesarean operation on a pregnant Italian woman who had been detained under mental health laws after suffering a breakdown at Stansted airport.
The treatment of Alexandra Pacchieri – whose baby was taken by Essex social workers for adoption in Britain – led to a renewed wave of calls for greater openness in the courts and from social and health workers who take life-changing decisions about families and patients behind closed doors.
The removal of the autistic man’s teeth came in a submission to peers by a group of lawyers who work regularly in the Court of Protection, which was set up by Labour’s mental capacity law to take decisions on health care and finance for people too ill to decide for themselves.
Led by barrister Victoria Butler-Cole, the lawyers said that among the defects of the law and the Court is ‘confusion about what counts as serious medical treatment and when health professionals need to go to court to obtain declarations.’
They added: ‘One example is a case in which an autistic young adult had all his teeth permanently removed to stop him self-harming, without the Court’s involvement.’
In keeping with the secrecy surrounding such decisions in the NHS, children’s and adult social work departments, and often in the family courts and the Court of Protection, no further details of the incident were discussed in nearly 2,000 pages of evidence which has now been published by the Lords committee.
The lawyers called for a string of reforms to the Mental Capacity Act and the Court of Protection, including changes to the ‘deprivation of liberty’ powers which allow judges to order someone to be detained in a care home.
The Lords committee, which is expected to report this year, was also told about research into the workings of the Act commissioned by the Department of Health, but never publicised.
Researchers from Bristol and Bradford Universities said aspects of the law were ‘worrying’ and criticised the way the Court of Protection decides when someone has no capacity to think for themselves.
They said there was confusion over ‘the distinction between unwise decisions and a lack of decision making capacity.’
The case of the young man whose teeth were taken out comes after months of growing disquiet at the high-handed and secretive behaviour of Court of Protection judges.
Concerns were raised in April last year after the Daily Mail revealed that a judge had jailed a woman called Wanda Maddocks for contempt of court after she tried to take her father away from a care home where he had been ordered to stay.
Miss Maddocks, who had no lawyer to represent her in court, was imprisoned secretly and no-one was allowed to know her name until the Mail investigated the case.
The most senior family court judge, Sir James Munby, has since ordered that no-one should ever again be jailed in secret.
He is also pressing judges to break the routine Court of Protection secrecy by publishing judgements. New rules are also expected this year to allow greater public access to Court of Protection hearings.
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