Mount Alvernia Hospital v LP: Declaration on Legality of Medical Treatment & Court's Inherent Jurisdiction
In *Re LP (adult patient: medical treatment)*, the High Court of Singapore, on 23 January 2006, addressed an urgent application by Mount Alvernia Hospital for a declaration that a proposed amputation of both legs of Mdm LP, a comatose patient, was lawful. The court, presided over by Choo Han Teck J, considered the patient's prior refusal to amputation, her current inability to consent, and the absence of a Committee of Person. The court ultimately granted the order, declaring the proposed surgery lawful, based on the medical opinion that it was in the patient's best interests.
1. Case Overview
1.1 Court
High Court1.2 Outcome
Order granted in terms of the application, declaring the proposed surgery lawful.
1.3 Case Type
Civil
1.4 Judgment Type
Grounds of Decision
1.5 Jurisdiction
Singapore
1.6 Description
The High Court considered an application for a declaration on the legality of a proposed amputation for a comatose patient, addressing the court's inherent jurisdiction.
1.7 Decision Date
2. Parties and Outcomes
| Party Name | Role | Type | Outcome | Outcome Type | Counsels |
|---|---|---|---|---|---|
| Mount Alvernia Hospital | Applicant | Corporation | Application Granted | Won | |
| LP | Respondent | Individual | Proposed surgery declared lawful | Neutral |
3. Judges
| Judge Name | Title | Delivered Judgment |
|---|---|---|
| Choo Han Teck | Judge | Yes |
4. Counsels
| Counsel Name | Organization |
|---|---|
| Chong Fook Choy Christopher | Rodyk and Davidson |
4. Facts
- Mdm LP, a 51-year-old diabetic patient, had a right foot infection with gangrene.
- She previously refused amputation of her right leg, wanting her legs saved at all costs.
- Mdm LP was admitted to Mount Alvernia Hospital.
- Mdm LP was found to be in septic shock and was not rousable.
- Doctors believed that bilateral below knee amputations were urgently needed to improve her condition.
- The patient's only known relative was her 16-year-old son, L.
- The patient was in a comatose state and unable to give consent.
5. Formal Citations
- Re LP (adult patient: medical treatment), OS 38/2006, [2006] SGHC 13
6. Timeline
| Date | Event |
|---|---|
| Mdm LP consulted Dr Tan at Gleneagles Medical Centre, complaining of pain in both feet. | |
| Mdm LP had an amputation of her right toe. | |
| Mdm LP was discharged. | |
| Mdm LP saw Dr Tan again; her condition had worsened. | |
| Mdm LP was found to be in septic shock and was not rousable. | |
| Doctors tried further operations to remove the infected parts of her legs without success. | |
| Judgment issued by the High Court. |
7. Legal Issues
- Jurisdiction of the High Court
- Outcome: The court held that it had inherent jurisdiction to hear the application.
- Category: Jurisdictional
- Sub-Issues:
- Inherent jurisdiction to hear application for consent in absence of Committee of Person
- Legality of Medical Treatment without Consent
- Outcome: The court declared the proposed surgery lawful, finding it to be in the patient's best interests.
- Category: Substantive
8. Remedies Sought
- Declaration that the proposed surgery is lawful
9. Cause of Actions
- No cause of actions
10. Practice Areas
- Injunctions
- Health Law
11. Industries
- Healthcare
12. Cited Cases
| Case Name | Court | Affirmed | Citation | Jurisdiction | Significance |
|---|---|---|---|---|---|
| St George’s Healthcare NHS Trust v S | N/A | Yes | [1999] Fam 26 | England and Wales | Cited regarding the circumstances under which applications ought not normally be made ex parte. |
| In re F | House of Lords | Yes | [1990] 2 AC 1 | United Kingdom | Cited for the principle that the court has inherent jurisdiction to hear an application for a declaration regarding medical treatment and that a proposed operation is lawful if it is in the best interests of the patient. |
| Re Quinlan | N/A | Yes | 70 NJ 10 (1975) | United States | Cited as an example of a US case where the court applied the “substituted judgment” test. |
13. Applicable Rules
| Rule Name |
|---|
| Rules of Court (Cap 322, R 5, 2004 Rev Ed), O 15 r 16 |
14. Applicable Statutes
| Statute Name | Jurisdiction |
|---|---|
| Mental Disorders and Treatment Act (Cap 178, 1985 Rev Ed) | Singapore |
| Supreme Court of Judicature Act (Cap 322, 1999 Rev Ed) | Singapore |
15. Key Terms and Keywords
15.1 Key Terms
- Medical treatment
- Amputation
- Inherent jurisdiction
- Best interests
- Consent
- Septic shock
- Comatose
- Declaration
- Mental capacity
15.2 Keywords
- Medical treatment
- Amputation
- Inherent jurisdiction
- Best interests
- Consent
- Septic shock
- Comatose
- Declaration
17. Areas of Law
| Area Name | Relevance Score |
|---|---|
| Medical Treatment Law | 90 |
| Mental Capacity Law | 85 |
| Civil Practice | 75 |
| Medical Malpractice | 60 |
| Administrative Law | 25 |
16. Subjects
- Medical Law
- Mental Health Law
- Civil Procedure
- Jurisdiction