ABSTRACT
In August 2019, a hospital sought a court declaration that a 20-year-old man lacked the capacity to make decisions about the palliative care that he was being offered, and to approve the proposed plan. At the time of the hearing, he was at home, very poorly, with his father. He had suffered severe aplastic anaemia for 5 years. He had undergone stem cell transplant earlier in the summer of 2019, which had been unsuccessful, partly because he had not consistently followed the recommended treatment plan. Since then, he had endured neutropaenic sepsis requiring intensive care; he had only recently been discharged. His early life had been characterised by significant harm inflicted by both birth and then foster families. This then had perhaps been exacerbated by the regular use of non-prescription drugs. His eventual diagnosis included a complex mixture of emotional dysregulation and psychological conditions loosely formulated as Asperger's syndrome, autism and personality disorder.
