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| 2 minutes read

"An obligation that comes from love" - Best interests are never easy, least of all in cases of medical treatment decisions

BBC One drama Best Interests has shone a powerful light on the role of the Court of Protection in medical treatment decisions where those entitled by law to be consulted about how a person lacking capacity should be medically treated disagree about what course of treatment - or whether to cease such treatment - is appropriate.

The four-part drama has focused on the family relationships surrounding the deteriorating health condition of Marnie, a 13-year-old girl with a form of muscular dystrophy. The drama illustrates the struggles of families to get the needs of a child with a disability fully met, the joys along the way of parenthood and the deep love and care involved in caring for a person with significant medical needs.

Whilst disagreements are understandable when the life of a loved one is at stake, the series has carefully portrayed the deep love of the parents and the deep care of the medical professionals, despite their differing views. The trust built up between families and professionals over years of treatment, the challenge that differing views can pose to the therapeutic and treating relationship and also the way in which the Court of Protection, as decision maker of last resort is there to explore and ultimately determine the most difficult of decisions - whether someone lives or dies.

Nicci, the mother in this case (played powerfully by Sharon Horgan) when on the witness stand in court speaks powerfully of the role disabled parents play - and feel they must play to advocate for their child in a societal system that is against them. Earlier in the series, she speaks of the fight many parents of children with disabilities face to constantly fight “for money, for wheelchairs, for breathing equipment, night-time support, educational support… while those in power try to cheat us out of what our children need” - a fight many of our clients, their parents and carers and we on their behalf as Court of Protection practitioners see so often.  

The legal portrayal was sensitively handled and shows the measured consideration, and the personalised approach the Court of Protection seeks to deliver in such circumstances. Marnie was seen and brought to life in the court proceedings despite being in a hospital bed miles away. But still, the court is tasked ultimately with making the most difficult of decisions, those of life and death.

In such cases, there is no right or wrong - only the unrelenting focus of best interests for the incapacitous person at the centre. There will always be differing perceptions of this assessment and none are wrong - all show a viewpoint that is legitimate, real and considered and the court must, in those cases, hold the ring to take all of those views into account and ascertain its determination of best interests. 

What this programme illustrated above all else, was the unswerving obligation of love - the love to fight for the best interests and best outcomes for the person lacking capacity and that regardless of what happens, that love lives on, and the fight for the rights of those with disabilities is a responsibility that families, medical and legal professionals and the court take seriously.

Like many others, I am proud to work within the Court of Protection arena and hold the assessment of best interests as a major part of my work. It's never easy and more often than not, the lack of a clear 'right' answer leaves an imprint of a case, of a person, of a life, on you as an individual. Like many practising in this area, it's an obligation of love - of a desire to care, to protect and above all to value those lacking capacity and to ensure their legal rights are protected and promoted.

A family faces a choice no parent wants to make. When your child is desperately ill, who decides what happens next? Heartbreaking drama with Sharon Horgan and Michael Sheen.


court of protection, personal injury, personal injury trusts, private legal services, probate, tax and estate planning, wills