Judge approves forced Caesarean for mentally-ill woman

Doctors have been granted permission to perform an urgent Caesarean section on a mentally-ill woman with diabetes.

High Court judge Mr Justice Hayden gave specialists at the Royal Free London NHS Trust approval after a five-hour hearing at the Court of Protection.

He said the decision was "draconian" but necessary because the mother's life may be in danger.

The woman, 32, who is 38 weeks pregnant, was deemed unable to make the decision over how to give birth.

The ruling, late on Friday, came after doctors applied for permission to carry out the delivery in order that the patient's "unstable mental state" could be treated.

A specialist from the trust told the Court of Protection in London, which specialises in issues relating to the sick and vulnerable, that their priority was "keeping this woman alive".

The judge heard how she was thought to have paranoid schizophrenia, had stopped eating and tried to kill herself during the night.

One doctor told the court that her mental and physical problems should improve and be easier to treat once the baby had been born.

The trust made an application to an out of hours judge on Thursday night but he decided as she had not gone into labour to delay the hearing until the morning so a barrister could be found to represent the woman.

Mr Justice Hayden ruled that neither the woman nor the hospital where she was treated should be named but the health authority should be named in order to "serve to reassure public confidence".

He added: "The decision to compel a Caesarean section on an incapacitous woman who is mentally and physically ill is an extremely draconian one.

"Doctors do not embark upon this lightly. It occurs extremely rarely. It is one that the lawyers also take very seriously indeed.

"I am perfectly satisfied that at the moment [this woman] is not able to make any reasoned evaluation of the advantages and disadvantages of a Caesarean section."

He concluded that the woman lacked the mental capacity to regulate her diabetic medicine and monitor her own intake of food and water.

In granting permission for the operation the judge stipulated that the patient should not be restrained or have force used against her.

A specialist advised the court that the baby would not be at risk if delivered via Caesarean section at 32 weeks.

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