SA is 22 years old and has a diagnosis of Autistic Spectrum Disorder, Severe Learning Disabilities, communication difficulties and Attention Deficit Hyperactivity Disorder. He was represented in the proceedings by the Official Solicitor as his litigation friend as he lacked capacity.
South Tyneside and Sunderland NHS Trust Foundation made an application for an order allowing them to examine SA’s mouth under general anaesthetic and provide such dental treatment as required, examine SA’s ears and perform suction clearance and/or insert grommets and take blood to monitor his current medication. The Trust submitted that these orders were in SA’s best interests as he appeared to be in pain and discomfort but, despite the best efforts of the relevant medical professionals, they had not been able to examine SA due to his lack of co-operation, levels of agitation and unpredictable behaviour.
SA’s mother did not consent to the proposed treatment but requested that the court consider whether any treatment SA did have included a frenectomy. This was not supported by the Trust. The Official Solicitor supported the Trust’s application in relation to the dental and ENT investigations but remained neutral in relation to the issue of the frenectomy.
The court heard oral evidence from SA’s Community Nurse, Residential Home Manager, Speech and Language Therapist, Senior Dental Officer and Consultant Oral and Maxillofacial Surgeon. At the conclusion of the evidence, the Official Solicitor was able to finalise her position that the frenectomy procedure was not in SA’s best interests, on the basis that the risks outweighed any benefit for SA of that procedure being undertaken.
The court subsequently granted the Trust’s application for the dental and ENT procedures and ruled that a frenectomy was not in SA’s best interests.
The full judgment can be read here.
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