In a previous briefing we reported on a case where the Court decided that a patient suffering from anorexia should be discharged rather than treated compulsorily using section 63 Mental Health Act[1].

The Court has recently decided a further case on the basis that the patient should be discharged rather than face compulsory treatment.


Miss Z was aged 46 and detained under the Mental Health Act. She had been diagnosed with anorexia 31 years previously but had never significantly engaged with treatment. She had an extremely low BMI and was held to lack capacity to make decisions as to whether to undergo treatment for her anorexia.

Three options for her treatment were placed before the Court:

  • Option 1 involved feeding under physical restraint until her weight and physical health improved.
  • Option 2 involved feeding under chemical sedation but with an acknowledgement that this carried risks in itself.
  • Option 3 was to discharge Miss Z from detention under the Mental Health Act and provide treatment only if she was prepared to engaged with this on a voluntary basis.

The Court’s decision

The Court commented that it was in effect considering three palliative care options. It acknowledged that the parents of Miss Z hoped that she would accept treatment and supported the proposal for her discharge.

The Court decided that she should indeed be discharged. It adopted the same approach as in the case of Miss W[3] and adopted the ‘least worst option’. The Court held that the third option, discharge, was ultimately the only option which carried any vestige of hope and preserved her dignity and autonomy.