The Supreme Court rules on deprivation of liberty case

R (on the application of Maguire) v His Majesty’s Senior Coroner for Blackpool & Fylde and another

Summary

In a judgment handed down on 21st June, the Supreme Court dismissed the appeal of Maguire v His Majesty’s Senior Coroner for Blackpool & Fylde – a decision concerning whether the death of a disabled woman who was deprived of her liberty engaged the state’s obligation to protect life under Article 2 ECHR, therefore requiring an inquest jury to make findings regarding the circumstances by which the death occurred.

Background

• Jacqueline Maguire, known as Jackie, was a lady with Down’s Syndrome who lived in a residential placement for adults with learning difficulties in Blackpool. She was deprived of her liberty pursuant to a Standard Authorisation made under the Mental Capacity Act 2005.
• Jackie died on 22 February 2017. In the weeks beforehand, she suffered symptoms including stomach pains, collapsing, and a sore throat. On the evening before her death, she repeatedly lost consciousness and collapsed. An ambulance crew attended but left after Jackie refused to attend hospital. A GP advised that whilst it was desirable that Jackie should attend hospital, her condition was not so serious that they should override her wishes and force her to go.
• The next morning, Jackie’s condition had worsened, and she again collapsed. She was admitted to hospital where shortly afterwards she suffered a fatal cardiac arrest. A post-mortem recorded her cause of death as a perforated gastric ulcer leading to peritonitis and pneumonia.
• An inquest into Jackie’s death took place in 2018. At the conclusion the coroner decided that Jackie’s death did not engage the state’s positive obligation to protect life under Article 2 ECHR. As a result, the jury was not required to consider the circumstances in which Jackie came by her death, and resultantly gave only a short narrative conclusion that Jackie’s death resulted from natural causes.

High Court / Court of Appeal

Jackie’s mother brought judicial review proceedings in respect of the coroner’s decision regarding Article 2. The High Court and Court of Appeal dismissed her claim following which she was granted permission to appeal to the Supreme Court.

Supreme Court

On 22 and 23 November 2022, the Supreme Court considered the obligations imposed by Article 2 on the care home and other healthcare providers and the systems and operational duties to take appropriate steps to safeguard the lives of those within their jurisdiction.

Judgment

Unanimously dismissing the appeal, the Supreme Court upheld the Coroner’s decision that neither the systems or the operational duty was, at the conclusion of the evidence, arguably breached – the Coroner had acted neither irrationally nor erred in law, holding:

“An individual such as Jackie is placed in a care home so that they can be provided with a substitute form of familial care when they are no longer able to look after themselves and their family cannot cope either. There may well be a deprivation of liberty according to the standards laid down under article 5 of the Convention, but this is for their own benefit. They are in a situation very different from a prisoner … In a care home or a nursing home, loss of liberty is an incidental feature of the vulnerability of the individual resident, and it is the vulnerability and the assumption of responsibility of care in the light of it which is the fundamental basis for the duties owed under article 2. The extent to which an individual may be vulnerable and requiring of protection is on a continuum which is different from the distinction between loss of liberty and freedom for the purposes of article 5 … many people, young and old, share Jackie’s characteristics of being vulnerable and unable to care for themselves, with increasing numbers of elderly adults being in a similar position as a result of diminished mental faculties or dementia; they may be accommodated in nursing homes or care homes or with their family, and substantial numbers will be subject to the DoLS regime to authorise stopping them from leaving, in the interest of keeping them safe. The stronger analogy in the case of a care home is with a situation in which the state has authorised loss of liberty at a family home in the interests of the individual, rather than with imprisonment. It is appropriate that the duties applicable under article 2 should reflect this different context.”

What does this mean?

In coming to the above decision, the Supreme Court have made it clear that those who are deprived of their liberty for the purposes of being provided with ‘familial care’ (such as the care provided within a care home setting) are not in the same situation as prisoners and other similar groups but have the same human rights protections that apply to the general population. In an inquest context therefore, this does of course mean that Jurys will not be invited to comment on any alleged failings.

For further information, please contact Catharine Busby or a member of our expert Health and Care Advisory Team.