If a patient lacks the mental capacity needed to give informed consent to a medical procedure, only a judge can provide the authority required to proceed. The High Court performed that vital role in opening the way for a gravely mentally ill woman to be delivered of her first child by caesarean section.
The woman was detained in a psychiatric intensive care unit. As the day planned for her caesarean delivery approached, her already serious condition deteriorated. She was very distressed and sometimes aggressive. After concerns were raised that she might be unable to give informed consent, NHS authorities that bore responsibility for her care applied to the Court. The emergency application was made the day before she was due to undergo the procedure.
Authorising the caesarean delivery, the Court found that it was plainly right that she lacked capacity either to litigate or to make an informed choice. Given her highly emotional state, a conventional delivery would be very risky, both to her and her baby. It was absolutely clear that a caesarean section, whilst not risk free, was the best obstetric option open to her.
The Court noted that, following its decision, the procedure had been successfully performed, without any need for restraint, and the woman had given birth to a baby boy. Although there were signs of foetal distress prior to his delivery, and he was being cared for in a neonatal intensive care unit, he was currently doing well.