A judge has ruled a mother-of-six with learning disabilities can be forcibly sterilized in a decision he described as “exceptional.”
Mr. Justice Cobb authorized health authorities and social services to force entry into the woman’s home and use “necessary restraint” in order to sterilize her.
The ruling was made at a hearing in the Court of Protection in London, where issues relating to sick and vulnerable people are examined.
Health authorities and social services had argued such a move was in the best interests of the woman, whose life would be in danger if she became pregnant again.
The judge said the medical, legal and ethical issues arising from the case were of the “utmost gravity” and insisted the decision was not about eugenics.
The woman, who is in her 30s, has had her children taken from her and has repeatedly refused to cooperate with medical and social services staff saying she wanted to be “left alone,” the judge was told.
Health and social services officials said they faced difficulties trying to persuade the woman to use contraception.
Barrister Michael Horne, who represented the interests of the woman, said sterilization was required to mitigate the “grave risks” she would face to her health if she became pregnant again.
Judge Cobb said she had a history of concealing or trying to conceal pregnancy from health workers.
He ruled last year the woman could be restrained and sedated when giving birth to her sixth child. A planned caesarean was determined to be best option for delivery.
Rannon Gillon, Emeritus Professor of Medical Ethics at Imperial College London, said such legal decisions must be made in the person’s best interests.
Speaking to RT, he said: “All actions taken on behalf of a person who does not have legal capacity to consent to or reject the proposed action must, under the Mental Capacity Act 2005, be taken in that person's best interests.”
He added it seemed clear the judge made his decision in the woman’s best interest because of the risk of death associated with future pregnancy.
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While acknowledging he didn’t know the details of the case, he said “in principle such a decision could be both legally and ethically in such a person's best interests.”
In a written judgment, Mr. Justice Cobb said the decision to authorize compulsory sterilization was “exceptional.”
He declared because the woman lacked the mental capacity to make decisions regarding contraception, “therapeutic sterilization” would be lawful and in her best interests.
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“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,” he wrote.
“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 risk to [the woman] of a future pregnancy, especially if concealed, is highly likely to lead to her death,” he added.
The judge authorized health and social services staff to: “Remove (the woman) from her home and take steps to convey her to hospital for the purposes of the sterilization procedure.”
He said “necessary and proportionate steps” could include “forced entry and necessary restraint.”