MKC [2021] NSWCATGD 38

NSW Civil and Administrative Tribunal New South Wales Medium Neutral Citation: MKC [2021] NSWCATGD 38 Hearing dates: 15 December 2021 Date of orders: 15 December 2021 Decision date: 15 December 2021 Jurisdiction: Guardianship Division Before: J Moir, Senior Member (Legal) Dr B McPhee, Senior Member (Professional) S Johnston, General Member (Community) Decision: Guardianship application 1. A guardianship order is made for MKC. 2. The Public Guardian is appointed as the guardian. 3. This is a continuing guardianship order for a period of 12 months from 15 December 2021. 4. This is a limited guardianship order giving the guardian custody of MKC to the extent necessary to carry out the functions below. FUNCTIONS: 5. The guardian has the following functions: a) Health care To decide what health care MKC may receive. b) Medical/Dental consent To make substitute decisions about proposed minor or major medical or dental treatment, where MKC is not capable of giving a valid consent. c) Restrictive Practices To give or withhold consent as to whether the restrictive practice of chemical restraint should be used to influence MKC's behaviour. CONDITIONS: 6. The conditions of this order are: a) Standard Condition In exercising this role the guardian shall take all reasonable steps to bring MKC to an understanding of the issues and to obtain and consider his views before making significant decisions. b) Restrictive Practices Condition The guardian may only consent to the use of the types of restrictive practices permitted under this order to influence MKC's behaviour: (i) as a last resort to prevent MKC harming himself or others; and (ii) in accordance with a behaviour support plan which has been developed by a behaviour support practitioner after having conducted a functional behavioural assessment upon MKC, and which is reviewed at least every 12 months and/or reviewed as soon as practicable if there is a change in circumstances which requires the plan to be amended. Consent to special medical treatment: The Tribunal consents to the following special medical treatment being provided to MKC: Cyproterone Acetate (Androcur) up to 25 mg a day and any necessary treatment that would normally be provided in association with or directly consequent upon the above treatment. This consent is effective for a period of four months from the date of this order. This consent is subject to the condition that during this period investigations should be conducted into whether MKC has developed any adverse effects from this medication, such as reduced bone density/osteopenia/osteoporosis or liver dysfunction. If prescription of this medication is required for longer than four months, a new application for the Tribunal's consent must be made. This should be accompanied by: results of any investigations into adverse effects; results from recent testosterone levels; records of behavioural data for the past six months; and updated information from his behavioural practitioner regarding the behavioural strategies being employed and the success of these in addressing the behaviour. Catchwords: CONSENT TO MEDICAL TREATMENT – application for consent to special medical treatment – Cyproterone Acetate (Androcur) – androgen reducing medication for the purpose of behavioural control – subject person not able to provide consent to medical treatment – finding that continued use of low dose of Androcur is in the subject person's best interests – consent given for a period of four months – condition that investigations should be conducted into any adverse side effects. GUARDIANSHIP – application for a guardianship order – subject person with an intellectual disability – subject person living in supported accommodation – restrictive practices – chemical restraint – need for a guardian to consent to the use of Androcur for behaviour control – need for decisions to be made in relation to health care and consent to medical and dental treatment – no private guardian available – Public guardian appointed – order made. Legislation Cited: Guardianship Act 1987 (NSW), ss 3(1)-(2), 4, 14, 14(2), 15(3), 33(2, 42(2), 45(3)(b); Pt 5 Guardianship Regulation 2016 (NSW), reg 14(b) National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 (Cth) Section) Cases Cited: IF v IG [2004] NSWADTAP 3 Texts Cited: None cited. Category: Principal judgment Parties: 005: Consent to Special Medical Treatment