Alex Ruck Keene
capacitylaw.bsky.social
Alex Ruck Keene
@capacitylaw.bsky.social
Barrister, writer and educator, mainly mental capacity, mental health and healthcare ethics. Bluesky largely used to share materials - for contact, please email me at [email protected].
Website: https://www.mentalcapacitylawandpolicy.org.uk
Suicide prevention and the legalisation of assisted dying / assisted suicide – new position statement from the International Association of Suicide Prevention

The International Association of Suicide Prevention published on 1 December a position statement on assisted suicide and euthanasia.  It is…
Suicide prevention and the legalisation of assisted dying / assisted suicide – new position statement from the International Association of Suicide Prevention
The International Association of Suicide Prevention published on 1 December a position statement on assisted suicide and euthanasia.  It is available here; I reproduce below the accompanying statement on its website. The International Association for Suicide Prevention (IASP) has released a Position Statement on Assisted Suicide and Euthanasia, reflecting growing global developments in legislation, policy, and public debate related to medically assisted dying.
www.mentalcapacitylawandpolicy.org.uk
December 2, 2025 at 4:34 PM
Mental capacity matters podcast now on Spotify

For those of you who like multi-tasking in the mental capacity and mental health zone, my shedinar series is now available as a podcast on Spotify as well as Apple. As a reminder, this is what we have so far (with more to come - and also updated…
Mental capacity matters podcast now on Spotify
For those of you who like multi-tasking in the mental capacity and mental health zone, my shedinar series is now available as a podcast on Spotify as well as Apple. As a reminder, this is what we have so far (with more to come - and also updated versions of some of the introductions ones when I have a moment).
www.mentalcapacitylawandpolicy.org.uk
December 2, 2025 at 12:24 PM
Capacity and marriage – the changes brought about in Ireland by the Assisted Decision-Making (Capacity) Act 2015

In the Matter of AB is an extremely interesting decision from the Circuit Court in Ireland.  It concerns the capacity of the man in question (the ‘relevant person’ using the language of…
Capacity and marriage – the changes brought about in Ireland by the Assisted Decision-Making (Capacity) Act 2015
In the Matter of AB is an extremely interesting decision from the Circuit Court in Ireland.  It concerns the capacity of the man in question (the ‘relevant person’ using the language of the Assisted Decision-Making (Capacity) Act 2015) to marry.  AB was in his forties and had an an intellectual disability. He had resided in a residential centre for a number of years, following the death of his parents. 
www.mentalcapacitylawandpolicy.org.uk
November 26, 2025 at 12:26 PM
Children in complex situations at risk of deprivation of liberty – in conversation with Dr Susannah Bowyer

In this 'in conversation' with, I talk to Dr Susannah Bowyer, Deputy Director at Research in Practice, about the recent research paper published by Research in Practice and the National…
Children in complex situations at risk of deprivation of liberty – in conversation with Dr Susannah Bowyer
In this 'in conversation' with, I talk to Dr Susannah Bowyer, Deputy Director at Research in Practice, about the recent research paper published by Research in Practice and the National Children's Bureau (commissioned by DfE) entitled (snappily) Improving the outcomes of looked-after children and young people in complex situations with multiple needs, at risk or subject to a Deprivation of Liberty.  
www.mentalcapacitylawandpolicy.org.uk
November 25, 2025 at 1:31 PM
Short note: communicating the communication limb of the capacity test

Re BV (Medical Treatment - Renal Cancer: Nephrectomy) EWCOP 41 (T3) is a relatively ‘routine’ medical treatment case (without, of course, diminishing its huge significance for the man in question).  It is a clear and thoughtful…
Short note: communicating the communication limb of the capacity test
Re BV (Medical Treatment - Renal Cancer: Nephrectomy) EWCOP 41 (T3) is a relatively ‘routine’ medical treatment case (without, of course, diminishing its huge significance for the man in question).  It is a clear and thoughtful example of the relevant statutory bodies and the court working through carefully to ensure that a patient detained under the MHA 1983 received appropriate treatment for an unrelated physical disorder.  
www.mentalcapacitylawandpolicy.org.uk
November 24, 2025 at 11:56 AM
Unofficial update to MCA Codes updated

There are two Codes of Practice to the Mental Capacity Act 2005, one for the main body of the Act, and one for the Deprivation of Liberty Safeguards. They are statutory Codes: they have been approved by Parliament, and the MCA 2005 requires certain people to…
Unofficial update to MCA Codes updated
There are two Codes of Practice to the Mental Capacity Act 2005, one for the main body of the Act, and one for the Deprivation of Liberty Safeguards. They are statutory Codes: they have been approved by Parliament, and the MCA 2005 requires certain people to have regard to them. Those people include anyone acting in a professional capacity. Neither Code of Practice has ever been updated since they were published, the main Code in 2007, and the DoLS Code in 2009.
www.mentalcapacitylawandpolicy.org.uk
November 20, 2025 at 3:21 PM
Natural justice and costs in the Court of Protection

Riddle v NA EWCOP 39 (T3) raises questions about the fitness for purpose of a key plank of the costs provisions contained in the Court of Protection Rules. The case took the form of an appeal against a decision of a District Judge refusing the…
Natural justice and costs in the Court of Protection
Riddle v NA EWCOP 39 (T3) raises questions about the fitness for purpose of a key plank of the costs provisions contained in the Court of Protection Rules. The case took the form of an appeal against a decision of a District Judge refusing the costs incurred by Andrew Riddle, who had sought to be appointed the professional deputy for a man, NA, but whose application had not been successful because it was ultimately shown that NA had the relevant capacity.
www.mentalcapacitylawandpolicy.org.uk
November 19, 2025 at 5:20 PM
50 years in mental health and capacity law – in conversation with Peter Edwards

In this 'in conversation with,' I talk to Peter Edwards, a solicitor who has just passed his 50 year mark working in mental health (and, since it became a 'thing' mental capacity law), and who has had quite the most…
50 years in mental health and capacity law – in conversation with Peter Edwards
In this 'in conversation with,' I talk to Peter Edwards, a solicitor who has just passed his 50 year mark working in mental health (and, since it became a 'thing' mental capacity law), and who has had quite the most extraordinarily varied and significant impact in ways that you might not be aware of.  The article that I mention which sets out some of the things that he has done is…
www.mentalcapacitylawandpolicy.org.uk
November 19, 2025 at 9:52 AM
Book review: Consenting Children (Lisa Forsberg, Isra Black and Anthony Skelton (eds))

Book Review: Lisa Forsberg, Isra Black and Anthony Skelton (eds), Consenting Children: Autonomy, Responsibility, Well-Being (Liverpool University Press: Proceedings of the British Academy 2025, 321 pp, hardback…
Book review: Consenting Children (Lisa Forsberg, Isra Black and Anthony Skelton (eds))
Book Review: Lisa Forsberg, Isra Black and Anthony Skelton (eds), Consenting Children: Autonomy, Responsibility, Well-Being (Liverpool University Press: Proceedings of the British Academy 2025, 321 pp, hardback / ebook £80) After a period where debates about the ability (both cognitive and legal) of children to make their own decisions seemed to have become largely confined to the classroom, they are now firmly back on the courtroom agenda in England & Wales, with cases over the last few years examining the (legal) capacity of children to…
www.mentalcapacitylawandpolicy.org.uk
November 16, 2025 at 4:32 PM
Holding the risk in medical treatment cases

Re RS (Best Interests: Surgery and Intensive Care) EWCOP 38 (T3) is a case which demonstrates the care and thought which – rightly – should go into ensuring that those with cognitive impairments are put forward for appropriate physical procedures, and…
Holding the risk in medical treatment cases
Re RS (Best Interests: Surgery and Intensive Care) EWCOP 38 (T3) is a case which demonstrates the care and thought which – rightly – should go into ensuring that those with cognitive impairments are put forward for appropriate physical procedures, and also contains some very helpful wider observations about the role of the courts in such cases. The person concerned was RS, a 18 year old man with a complex range of physical and cognitive impairments. 
www.mentalcapacitylawandpolicy.org.uk
November 8, 2025 at 1:03 PM
November 2025 39 Essex Chambers Mental Capacity Report now out – and walkthrough

The November 2025 Mental Capacity Report is now out.  Highlights this month include: (1) In the Health, Welfare and Deprivation of Liberty Report: Cheshire West 2, the return of LPS and where the buck stops with…
November 2025 39 Essex Chambers Mental Capacity Report now out – and walkthrough
The November 2025 Mental Capacity Report is now out.  Highlights this month include: (1) In the Health, Welfare and Deprivation of Liberty Report: Cheshire West 2, the return of LPS and where the buck stops with termination; (2) In the Property and Affairs Report: accessing Child Trust Funds and LPA fee increase; (3) In the Practice and Procedure Report…
www.mentalcapacitylawandpolicy.org.uk
November 7, 2025 at 4:28 PM
Capacity, decisions to end one’s own life, and the Terminally Ill Adults (End of Life) Bill

Following on from my evidence to the House of Lords Select Committee considering the Terminally Ill Adults (End of Life) Bill (see here), I have recorded this which seeks to dig further into the…
Capacity, decisions to end one’s own life, and the Terminally Ill Adults (End of Life) Bill
Following on from my evidence to the House of Lords Select Committee considering the Terminally Ill Adults (End of Life) Bill (see here), I have recorded this which seeks to dig further into the complexities around capacity, decisions to end one's own life, and the implications for the Terminally Ill Adults (End of Life) Bill, in particular as regards the positive obligations imposed on the State by Article 2 ECHR.
www.mentalcapacitylawandpolicy.org.uk
November 7, 2025 at 2:17 PM
Is mental capacity law law? In conversation with Professor John Coggon

In this 'in conversation with,' I talk to Professor John Coggon about his - deliberately! - provocative new paper Is Mental Capacity Law Law?.  We think about what 'law' means in this context, and what judges are doing in legal…
Is mental capacity law law? In conversation with Professor John Coggon
In this 'in conversation with,' I talk to Professor John Coggon about his - deliberately! - provocative new paper Is Mental Capacity Law Law?.  We think about what 'law' means in this context, and what judges are doing in legal terms when they are judging in the Court of Protection.  And I charge John with nihilism... The paper that I mention towards the end by Bernadette Wren is this one: Can the courts be viewed as an appropriate vehicle to settle clinical unease?
www.mentalcapacitylawandpolicy.org.uk
November 7, 2025 at 12:13 PM
Fact finding in the Court of Protection

In Nottinghamshire County Council v SV & Anor EWCOP 37 (T3), Lieven J has provided a helpful recap of the approach to the question of when it is necessary to carry out a fact finding hearing in the context of Court of Protection proceedings. As she noted:…
Fact finding in the Court of Protection
In Nottinghamshire County Council v SV & Anor EWCOP 37 (T3), Lieven J has provided a helpful recap of the approach to the question of when it is necessary to carry out a fact finding hearing in the context of Court of Protection proceedings. As she noted: 48. Finding of fact hearings are relatively rare in Court of Protection cases.
www.mentalcapacitylawandpolicy.org.uk
November 6, 2025 at 5:56 PM
Terminally Ill Adults (End of Life) update

As many will know, the House of  Lords convened a Select Committee to consider the Bill, which heard from witnesses in late October / early November.  It has now finished its evidence sessions.  The transcripts of the oral evidence given by witnesses can…
Terminally Ill Adults (End of Life) update
As many will know, the House of  Lords convened a Select Committee to consider the Bill, which heard from witnesses in late October / early November.  It has now finished its evidence sessions.  The transcripts of the oral evidence given by witnesses can be found here; their written evidence can be found here.  My oral evidence to the Committee can be found…
www.mentalcapacitylawandpolicy.org.uk
November 6, 2025 at 4:15 PM
Book Review: János Fiala-Butoria, Implementing the Right to Decide under the Convention on the Rights of Persons with Disabilities: Supporting the Legal Capacity of All Persons with Disabilities

Book Review: János Fiala-Butoria, Implementing the Right to Decide under the Convention on the Rights…
Book Review: János Fiala-Butoria, Implementing the Right to Decide under the Convention on the Rights of Persons with Disabilities: Supporting the Legal Capacity of All Persons with Disabilities
Book Review: János Fiala-Butoria, Implementing the Right to Decide under the Convention on the Rights of Persons with Disabilities: Supporting the Legal Capacity of All Persons with Disabilities (Bloomsbury, 2025, 167 pp, hardback / ebook, £81.00 / £64.80) I should start this review with a confession. I asked to be provided with this book for review out of a slight sense of duty, so as to keep myself abreast of the literature in this area. 
www.mentalcapacitylawandpolicy.org.uk
October 29, 2025 at 6:26 PM
Deprivation of liberty update – the Supreme Court, DHSC and CQC

Three important developments, on different timelines, have occurred in relation to deprivation of liberty. The first is the publication on 23 October by the CQC of their annual State of Care Report, which includes a specific section…
Deprivation of liberty update – the Supreme Court, DHSC and CQC
Three important developments, on different timelines, have occurred in relation to deprivation of liberty. The first is the publication on 23 October by the CQC of their annual State of Care Report, which includes a specific section under 'groups of people of concern' on deprivation of liberty.  It is a long section, but I reproduce the opening paragraphs here: We have raised serious concerns about the safeguards and the need for system-wide reform for a number of years.
www.mentalcapacitylawandpolicy.org.uk
October 26, 2025 at 9:38 AM
Termination, best interests and where the buck stops

Even by the standards of the Court of Protection, Re KP (Termination of Pregnancy) EWCOP 35 (T3) is a difficult case.  It concerned a 19 year old woman who, in Poole J’s understated summary had “experienced very many challenges in her life,”…
Termination, best interests and where the buck stops
Even by the standards of the Court of Protection, Re KP (Termination of Pregnancy) EWCOP 35 (T3) is a difficult case.  It concerned a 19 year old woman who, in Poole J’s understated summary had “experienced very many challenges in her life,” starting at birth when hypoxia led to an acquired brain injury. She was now 17 weeks pregnant.  The questions before Poole J were:
www.mentalcapacitylawandpolicy.org.uk
October 15, 2025 at 11:28 AM
39 Essex Chambers October 2025 Mental Capacity Report and walkthrough

Welcome to the October 2025 Mental Capacity Report. Highlights this month include: In the Health, Welfare and Deprivation of Liberty Report: time-specificity of capacity (again), a Welsh primer on key caselaw and urban myths…
39 Essex Chambers October 2025 Mental Capacity Report and walkthrough
Welcome to the October 2025 Mental Capacity Report. Highlights this month include: In the Health, Welfare and Deprivation of Liberty Report: time-specificity of capacity (again), a Welsh primer on key caselaw and urban myths around s.4B MCA 2005; In the Property and Affairs Report: two guest articles from new members of the Court of Protection on attorney elephant traps;
www.mentalcapacitylawandpolicy.org.uk
October 4, 2025 at 8:34 AM
Motability, contracts and deputies

[I set out here a press release from the Office of the Public Guardian - the 'clarification' relates to a consent order, rather than a judgment.  If / when the consent order is made public I will add it to this page] On 18 July 2025, the Court of Protection…
Motability, contracts and deputies
[I set out here a press release from the Office of the Public Guardian - the 'clarification' relates to a consent order, rather than a judgment.  If / when the consent order is made public I will add it to this page] On 18 July 2025, the Court of Protection clarified how vehicle contracts under the Motability Scheme should be handled when arranged by a deputy.
www.mentalcapacitylawandpolicy.org.uk
September 30, 2025 at 2:40 PM
How to draft an assisted dying law – a governmental perspective from Jersey

As many will know, by contrast to the position in England and Wales (and indeed Scotland), moves towards legislating for assisted dying / assisted suicide are being taken forward in Jersey as Government legislation.  The…
How to draft an assisted dying law – a governmental perspective from Jersey
As many will know, by contrast to the position in England and Wales (and indeed Scotland), moves towards legislating for assisted dying / assisted suicide are being taken forward in Jersey as Government legislation.  The draft Bill has now been published, and the draft with its accompanying report should, I suggest, make mandatory reading for Parliamentarians in 'mainland' UK jurisdictions. 
www.mentalcapacitylawandpolicy.org.uk
September 25, 2025 at 3:22 PM
Transparency in the Court of Protection – what is it good for and how long should restrictions last?

By accident or design, Poole J appears to have found himself the Tier 3 transparency guru.  In Re Gardner (Deceased)(Duration of Transparency Order) EWCOP 34 (T3) he made a range of important…
Transparency in the Court of Protection – what is it good for and how long should restrictions last?
By accident or design, Poole J appears to have found himself the Tier 3 transparency guru.  In Re Gardner (Deceased)(Duration of Transparency Order) EWCOP 34 (T3) he made a range of important observations about (and in passing raised some questions about) the operation of the transparency framework within the Court of Protection. As Poole J identified at the outset: 1. This is the third judgment I have published in these proceedings.
www.mentalcapacitylawandpolicy.org.uk
September 25, 2025 at 11:13 AM
The CRPD, the state and civil society – in conversation with Professor Peter Bartlett

In this 'in conversation with,' I talk to Professor Peter Bartlett about his article "Beyond the liberal subject: challenges in interpreting the CRPD, and the CRPD’s challenges to human rights," and discuss how…
The CRPD, the state and civil society – in conversation with Professor Peter Bartlett
In this 'in conversation with,' I talk to Professor Peter Bartlett about his article "Beyond the liberal subject: challenges in interpreting the CRPD, and the CRPD’s challenges to human rights," and discuss how the CRPD challenges conventional civil and political rights, the implications for the role of the state (and what happens if the state is not benign), and what the CRPD requires of civil society.
www.mentalcapacitylawandpolicy.org.uk
September 25, 2025 at 7:00 AM
Wishing won’t make it so – urban myths around s.4B MCA 2005

I was contacted, again, by a health care professional who had been told with complete confidence that the new version of s.4B MCA 2005 included in the Mental Capacity (Amendment) Act 2019 was in force.  This, in turn, meant that they had…
Wishing won’t make it so – urban myths around s.4B MCA 2005
I was contacted, again, by a health care professional who had been told with complete confidence that the new version of s.4B MCA 2005 included in the Mental Capacity (Amendment) Act 2019 was in force.  This, in turn, meant that they had been told with complete confidence that it was possible to deprive someone of their liberty in an emergency where they lacked capacity to consent to the steps required to provide them with life-sustaining treatment, or to prevent a serious deterioration in their confidence, and to rely in so doing on the protections contained in s.4B.
www.mentalcapacitylawandpolicy.org.uk
September 23, 2025 at 10:41 AM
Anticipating the reasonableness of responses – time-specific capacity in action

Darlington Borough Council v AW & Ors EWCOP 33 (T3), decided in August 2025, but only published more recently, is another in a now near-continuous stream of cases grappling with complexities of applying the…
Anticipating the reasonableness of responses – time-specific capacity in action
Darlington Borough Council v AW & Ors EWCOP 33 (T3), decided in August 2025, but only published more recently, is another in a now near-continuous stream of cases grappling with complexities of applying the time-specific MCA 2005 in real life. The facts of the case are disturbing, both in the depths of the despair that they illuminated on the part of the young person involved, and also for the fact that they are by no means uncommon. 
www.mentalcapacitylawandpolicy.org.uk
September 23, 2025 at 8:26 AM