Landmark ruling on the right to disagree with our doctors

A landmark judgement at the Court of Appeal, informed by expert analysis from University of Essex researchers, will help secure the rights of patients who disagree with their doctors.

The judgement in the posthumous case of Sudiksha Thirumalesh overturned a long-standing legal precedent stating that if someone does not accept their medical diagnosis or prognosis, they lack the ability to make decisions about their care.

Professor Wayne Martin, an Essex philosopher, provided Sudiksha’s legal team with expert analysis of the legal and ethical issues relating to the precedent, known as the MM Dicta.

Huge victory

Speaking after the judgement, Professor Martin said: “This judgement is a huge victory, not only for the family of Sudiksha Thirumalesh but for anyone facing tough decisions about their treatment.”

Sudiksha Thirumalesh, a 19-year-old-student, died in September 2023 following a widely-publicised ruling by the Court of Protection that she lacked mental capacity for treatment decisions.

That ruling effectively ended her quest to seek experimental medical treatment for a rare and debilitating mitochondrial disorder.

The lower court’s decision was based on a legal precedent known as the MM Dicta, which state that a person who does not believe information cannot be said to understand it and is unable to use and weigh it in making their own choice.

Fundamental question

Professor Martin supported the legal team at charity MIND in their intervention in the case and provided the Courts with analysis of the MM Dicta, based on his research as Director of the Essex Autonomy Project.

The key moment in the hearing in May came when Vikram Sachdeva, KC, acting for the University Hospitals Birmingham NHS Foundation Trust, conceded that the MM Dicta are incorrect, and orally revised the Trust’s earlier submission to the court.

Professor Martin said: “This hard-won point of consensus on a fundamental question of medical law offers fresh hope to anyone who disagrees with their medical team, or indeed with the medical establishment as a whole."