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Anorexic teenager can be treated against her will

AN ANOREXIC teenager can be treated for the potentially fatal illness against her will, the Court of Appeal ruled yesterday, after a drastic deterioration in the girl's condition.

The ruling, which undermines the right of 16 and 17-year-olds to refuse medical treatment, was delivered after the court was told that the weight of the 16-year-old, identified only as J, had dropped to 5st 7lbs (35kgs). She is 5ft 7ins (1.7m).

John Samuels QC, for the local authority responsible for J, said she had eaten nothing since some cornflakes nine days ago and was existing on 12 cups of tea a day.

J had appealed against an earlier High Court ruling which authorised her local authority to move her from a residential psychiatric unit to a centre for eating disorders. The girl, supported by her consultant, wanted to remain where she was. The move was deferred pending the appeal.

Allan Levy QC, for the girl, said on Monday that her condition was 'not life-threatening'. Yesterday all parties agreed that her current state necessitated a judgment from Lord Donaldson, Master of the Rolls, and Lords Justice Balcombe and Nolan as soon as possible.

Mr James Munby QC, instructed as an impartial expert by the Official Solicitor, said: 'Your Lordships are faced with the case of a girl who has currently embarked on a course which may endanger her life. There is also very real concern that, apart from life and death, if her present condition continues she may suffer very serious and irreversible damage both to her brain and her reproductive organs.' After a short adjournment, the judges ruled that J's views were 'of no weight' when it came to the court determining which form of treatment she should have. Today they will hear medical opinion. J's parents both died before she was 10. She had unsuccessful foster placements and anorexia was diagnosed four months after the death of her much-loved grandfather in 1990.

The council originally went to court to clarify its position after J had to be fed by nasal tube and her arms encased in plaster to stop her interfering with the tube or causing sores by picking her skin.

Mr Munby said the girl was now 'martyring' herself. He read a statement from J's aunt. 'She respects J's wishes, but she is concerned that the adolescents with whom J is in contact at the (council residential) unit are not helping her. She is adamant . . . that J should not be allowed to die.'

Mr Levy had argued that the girl was over 16, understood the implications of what she was asking and was legally old enough to refuse treatment.

Rachel Hodgkin, of the Children's Legal Centre, said that Lord Donaldson had reached a 'grave decision' which undermined the right of 16 and 17-year- olds, under the 1969 Family Law Reform Act to refuse treatment. She said the girl should have been detained under the Mental Health Act like an adult. The ruling left 16 and 17-year-olds in the position of having the right to consent to, but not refuse, treatment.

The Court of Appeal issued an injunction banning publication of any information that could identify the girl.

Leading article, page 20