Court of Protection make Best Interest Decision for P to relocate to another country for Medical Treatment

The Court of Protection makes crucial decisions for individuals who lack mental capacity. Those decisions relate to a person’s Property and Finances or Health and Welfare. The Health and Welfare matters before the Court of Protection cover a wide range of issues, ensuring that the protected party’s receive care aligned with their best interests. Typical decisions include where a person should live, what medical treatment they should receive and how their day-to-day care is managed. The Court also rules on sensitive matters such as consent to marriage or sexual relations, withdrawal of life-sustaining treatment and challenges to deprivation of liberty. When families, local authorities or healthcare providers cannot agree, the Court of Protection steps in to make an appropriate decision. Each decision is guided by the individual’s wishes, feelings and dignity, balancing autonomy with protection. Ultimately, the Court of Protection acts as a vital safeguard for those unable to make these life-changing choices themselves.

Decisions concerning medical treatment alone can vary with decisions being made to cover all aspects of potential treatment. This may include where treatment should be administered, as seen in the recent case of A London NHS Trust v DT (by her litigation friend, the Official Solicitor) and another[1] during which the Court of Protection considered whether DT should be transferred to another country for the treatment she required. This case concerns DT, a 42-year-old woman who collapsed at an overseas airport in August 2025 after feeling unwell during a flight. She suffered multiple cardiac arrests and was placed on mechanical ventilation after sustaining a severe hypoxic-ischaemic brain injury. Despite intensive treatment, DT remained unresponsive and MRI scans displayed catastrophic brain damage. Clinicians believed that DT was brain stem dead and sought to confirm this through tests. DT’s family, however, opposed testing in the UK and requested her transfer to another country, Country W, for testing and withdrawal of treatment in line with her cultural and religious beliefs. Proceedings were issued as DT lacked capacity to make the decision herself and thereafter the NHS and family could not reach a decision with regards to the treatment and where such treatment should be administered.

The Court of Protection assessed DT’s best interests by considering medical, emotional, cultural and social factors. Key elements included DT’s past and present wishes, her strong ties to Country W, being where she was born and lived for the past decade, and her religious and cultural beliefs regarding end-of-life rituals. Evidence was provided from DT’s sister highlighting DT’s desire to be in Country W if critically ill, as seen with previous medical treatment decisions. The Court weighed these against the futility of ongoing treatment, risks of transfer to Country W and the clinicians’ concerns about delay. It also noted that the legal position was that DT was not dead until brain stem testing confirmed it, therefore requiring a decision on where testing should occur.

The Court of Protection determined that DT should be transferred to Country W for brain stem testing and subsequent withdrawal of treatment. Applying the Mental Capacity Act 2005, the Court focused on DT’s best interests, considering her strong cultural, religious and personal ties to Country W. The Court acknowledged the risks of transfer and the continuation of treatment deemed clinically futile, but concluded these were outweighed by DT’s likely wishes, beliefs and values.

This case demonstrates that the Court of Protection is able to make decisions for a protected party to be relocated for the purpose of medical treatment and again reinforces the factors the Court will consider when making a decision.

[1] [2025] EWCOP 36