ABSTRACT
The judiciary present the decisions of the teenagers refusing treatment as irrational and, although this is not sufficient to lead to a conclusion that they lack competence, it does contribute to the portrayal of the teenagers as childlike. It is interesting to note that Lord Donaldson in Re W was not only clearly of the opinion that W’s refusal to transfer to a different centre for treatment of anorexia was irrational but, further, his personal belief was that ‘religious or other beliefs which bar any medical treatment or medical treatment of particular kinds are irrational’.60 However, in those cases where religious beliefs were material to the decision, the general rationality of holding those beliefs was not questioned whilst the belief of the individual was. In all cases, the court expressed doubts about the reasoning underlying the belief. Sir Stephen Brown accepted the evidence of Dr Cameron, consultant child psychiatrist, that L’s refusal was based on a ‘very sincerely, strongly held religious belief’ but one which ‘does not in fact lend itself in her mind to discussion’, unlike ‘the constructive formulation of an opinion which occurs with adult experience’.61 S’s explanation for her refusal was considered inadequate by the court. Johnson J quoted Dr S, consultant child psychiatrist: ‘There were a lot of things that concerned me, the patness of her replies, some of her phrases. She and her mother were using exactly similar phraseology. S was not able to explain her thoughts except that, “it was said in the Bible”.’62 The extent to which S was willing and able to articulate in acceptable terms the reasons for her refusal led to conclusions about her understanding. E’s sincerely and long held beliefs were dismissed as attributable to the enthusiasm of youth:
The values of the teenagers are acknowledged but are dismissed as irrational, unreasonable beliefs.
