Rachel is 30 years old and suffers from episodes of mental illness, during which,

among other things, she experiences delusional beliefs. During such a period of mental

illness, Rachel sustains a serious injury to her knee, requiring urgent surgery. Without

the surgery, doctors tell her it is unlikely she will be able to walk again. Though Rachel

appears initially to understand what the doctors are telling her, there are doubts over

whether she can retain that information long enough to make a decision. She is

currently refusing treatment because she says that the Gods will heal her knee. When

not experiencing mental illness, Rachel is a keen runner, and has made clear in the

past how much she enjoys keeping fit by running.

Gunther is a 70-year-old man with a kidney disease requiring dialysis treatment. He

also has a form of dementia. Without dialysis treatment, Gunther is not expected to live

beyond a few months, but with treatment, the prognosis is good. Gunther is refusing

treatment, though his grown-up children want him to have it.

Keira, a 28-year old woman, has severe mental disabilities and lives alone. She has

been assessed as functioning cognitively and emotionally at the level of a child of

around 12 years of age. Keira believes she is in a ‘loving relationship’ with Nihal,

though in reality they have had little physical contact to date, and Nihal has been in

prison for most of the time they have known each other. They have never lived together

but Nihal is due to be released from prison soon and plans to move in with Keira. Keira

says she is ‘excited’ by this prospect. Nihal has a conviction for the rape of a previous

partner, who herself had severe mental disabilities. Social services are very concerned

for Keira’s safety and have begun court proceedings to prevent Keira from embarking

a sexual relationship with Nihal.

Advise the parties on the issues of capacity and consent under the Mental

Capacity Act- UK.