A judge has decided that a mother-of-six who has learning disabilities can be sterilised in a UK case which he says raises “ethical, legal and medical issues” of the “utmost gravity”.
Mr Justice Cobb also ruled that social services staff and medics could force their way into the 36-year-old woman’s home and restrain her if necessary.
And he said officials did not need to tell the woman – or her long-term partner - when she would be sterilised
Detail of his decision emerged today in a written ruling following a hearing in the Court of Protection – where issues relating to sick and vulnerable people are analysed – in London.
Health authority and social services bosses had asked Mr Justice Cobb to authorise forced entry, ”necessary restraint” and sterilisation at a hearing in the Court of Protection – where issues relating to sick and vulnerable people are examined – in London.
They said such moves were in the best interests of the woman.
The judge did not identify anyone involved.
Specialists had told how the woman had physical health problems which could put her life in danger if she became pregnant again.
Officials acknowledged that the rulings they wanted were ”extraordinary” but said the woman’s health – and life – could be at ”grave” risk if action was not taken.
Mr Justice Cobb today granted their applications.
The judge described the case as “exceptional” and said the circumstances were “extreme”.
He said the case was not about eugenics – and said a further pregnancy could threaten the woman’s life.
The judge was told that the woman’s children had been taken from her care.
Lawyers appointed by the court to represent her interests had backed the plan put forward by health and social services officials and agreed that the woman ”lacks capacity” because her mind is ”impaired”.
Barrister John McKendrick, who represented health authority and council officials involved in the case, had told the judge that the nature of the rulings sought was ”extraordinary” and involved significant interference with the woman’s basic human rights. But he said the moves were necessary.
And barrister Michael Horne, who represented the interests of the woman, said sterilisation was ”therapeutic” and the most effective way of mitigating ”grave risks” to the woman’s health and life.
Mr Justice Cobb was told that the woman – and her partner – had repeatedly refused to co-operate or engage with medical and social services staff and a legal representative.
She had said she wanted to be ”left alone”.
The judge had seen evidence from psychiatrists, an obstetrician and gynaecologist as well as social workers.
Reports contained detail of a number of gynaecological problems which specialists said would pose a grave risk to the woman's health if she became pregnant again.
And he was told of difficulties professionals had faced in persuading the woman to use contraception and in administering contraception.
Mr Justice Cobb said last year he had authorised the administration of a contraceptive injection and medics had entered her home by force. The judge said the woman had been “so distressed” that he said it was no longer “feasible” to continue with injections.
“The ethical, legal and medical issues arising here are self-evidently of the utmost gravity, engaging, and profoundly impacting upon (the woman’s) personal autonomy, privacy, bodily integrity, and reproductive rights,” said Mr Justice Cobb in a written ruling published today.
“This is, in my judgment, an exceptional case on its facts; the applicants seek a range of relief which is likely to arise only in the most extreme circumstances.”
The judge said the woman had a history of concealing or attempting to conceal pregnancies from health professionals.
And he added: “This case is not about eugenics. This outcome has been driven by the bleak yet undisputed evidence that a further pregnancy would be a significantly life-threatening event for (the woman).
“The applicants’ obstetric, gynaecological and contraceptive experts strongly recommend this treatment for (the woman), jointly expressing themselves in these stark terms: ’The risk to (the woman) of a future pregnancy, especially if concealed, is highly likely to lead to her death’.”
Mr Justice Cobb declared that the woman lacked the mental capacity to make decisions regarding contraception.
The judge concluded that “therapeutic sterilisation” would be lawful and in the woman’s best interests.
He authorised medics and social services staff to: “Remove (the woman) from her home and take steps to convey her to hospital for the purposes of the sterilisation procedure.”
And he said “necessary and proportionate steps” could include “forced entry and necessary restraint”.