“In this Act, references to appropriate medical treatment, in relation to a person suffering from mental disorder, are references to medical treatment which is appropriate in his case, taking into account the nature and degree of the mental disorder and all other circumstances of his case.” 9.2. So, what does “appropriate” actually mean? The obligation to take into account the nature and degree of the patient’s mental disorder indicates that “appropriateness” is a clinical concept. But what are we supposed to take from “all other circumstances of his case”? 9.3. SH v Cornwall Partnership NHS Trust[2012] UKUT 290 (AAC) , concerned a patient who, like Miss M, was a community patient who had not been recalled to hospital. Judge Jacobs considered the relevance of a patient’s consent to the question whether treatment was “appropriate” and “available” for the purposes of section 72(1)(c) MHA. He said at [14] that: “The delivery of treatment, and the related issue of consent, is practically and conceptually distinct from the issue whether it is appropriate and available. Treatment may be appropriate, whether or not the patient consents. And it may be available, whether or not the patient is willing to receive it. Appropriateness and availability are issues that arise prior to the decision whether to give the treatment. It is only at that later stage that the patient’s consent arises.”
“capable of being employed with advantage or turned to account; hence, capable of being made use of, at one's disposal, within one's reach.” 10.3. When read in the context of the statutory scheme as a whole it is this last meaning which is most apposite: having determined that the treatment relied upon is clinically appropriate the Tribunal must also be satisfied, as a practical matter, that the treatment proposed is one that can be provided should consent be forthcoming. Or, in Judge Jacobs’ words in SH v Cornwall Partnership NHS Trust, “it must be both suitable for, and at the disposal of, patients”