R v Bournewood Community and Mental Health Trust ex parte L (Secretary of State for Health & Ors intervening)

[1998] 3 All ER 289
Download Judgment: English

L, who was profoundly mentally retarded and incapable of consenting to medical treatment, was admitted informally for in-patient treatment by an National Health Service Trust as he appeared fully compliant and did not resist admission. As a consequence the Trust avoided invoking the Mental Health Act regime. L applied, by his next friend, for judicial review of this decision, a writ of habeas corpus and damages for false imprisonment and assault.


[Adapted from INTERIGHTS summary, with permission]

Held that:

  1. Informal admission under s 131(1) of the Act encompasses patients, who although incapable of consent, do not object to treatment. This minimises the use of compulsory powers in circumstances where the patient has neither objected to nor expressed a positive desire for treatment. Such treatment, which might otherwise have constituted an invasion of L's civil liberties, can also be justified under the common law doctrine of necessity.
  2. (Lord Nolan and Lord Steyn dissenting) As L had not attempted to leave and was kept in an unlocked ward it could not be said that he had actually been deprived of his liberty. Lord Steyn (dissenting in part): L was detained because the health care professional's intentionally assumed control over him amounted to complete deprivation of liberty. Obiter: The effect of the House's decision is to leave compliant incapacitated patients without the safeguards enshrined in the Act.
  3. However, their moral right to dignity requires that they should have certain safeguards.


[Adapted from INTERIGHTS summary, with permission]