Beyond Cheshire West: liberty, consent and safeguarding adults with acquired brain injury

Purpose This practice paper aims to examine the implications of the Supreme Court judgment in Attorney General for Northern Ireland (AGNI) (Deprivation of Liberty) [2026] UKSC 16 for adults living with acquired brain injury (ABI), using ABI as a safeguarding lens through which to consider the wider implications of the decision for social work practice. Design/methodology/approach This conceptual paper critically analyses the AGNI judgment alongside literature relating to ABI, impaired self-awareness (insight), suggestibility and coercive control to explore the implications of the revised deprivation of liberty framework for assessment and safeguarding practice. Findings The paper argues that increased emphasis on subjective evidence of consent presents particular challenges for adults with ABI, whose impairments may affect recognition of restrictions, appreciation of alternatives or ability to resist influence whilst appearing cognitively intact. Compliance or dissent should not be assumed to reflect autonomy without careful professional scrutiny. Research limitations/implications The paper is conceptual and does not present empirical findings. It identifies the need for future research exploring the implementation of AGNI across different populations and practice settings, particularly where hidden disabilities may influence assessment of consent and liberty. Practical implications The paper proposes practical considerations for adult safeguarding professionals undertaking assessments of capacity, liberty and best interests in the post-AGNI landscape, emphasising careful exploration of autonomy, acquiescence, coercion and influence. Social implications The paper highlights the importance of ensuring that reforms intended to strengthen autonomy do not inadvertently reduce safeguards for individuals whose impairments may make meaningful consent difficult to recognise. Originality/value This is the first paper, to the best of the authors’ knowledge, to examine the implications of AGNI through the specific lens of ABI, offering an interdisciplinary social work perspective on the relationship between autonomy, safeguarding and deprivation of liberty.