A pregnant mentally-ill woman could be forced to have a caesarean section after a High Curt judge gave doctors permission to perform the procedure. Ruling in the Court of Protection in London on Wednesday, Justice Peter Jackson said medics could use "force" when dealing with the woman and that they would be allowed to sedate her.
Having been told the woman had "very severe mental health difficulties", the judge concluded that she lacked the mental capacity to make a potentially life-saving decision if doctors decided that a caesarean section was needed when she was in labour.
The Court of Protection is part of the High Court and examines issues relating to vulnerable and sick people. Doctors said there was a risk that a scar from a previous Caesarean section might rupture during delivery and put the woman's life at risk.
They said if that happened a caesarean section could be needed and NHS trust bosses responsible for her care asked the judge to make a ruling on what measures could be taken.
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The judge concluded that it was in the best interests of the woman - who is around 36 weeks pregnant - to plan ahead. He made the decision after hearing submissions from a court-appointed-lawyer representing the woman, a lawyer representing the trust and evidence from doctors involved.
Jackson analysed the case at a hearing in open court but he said reporters could not identify the woman or the NHS trust. He concluded that if the trust was named there was a risk that the woman could be identified. The lawyer representing the trust told the judge that the woman was 36, had three children and was suffering from paranoid schizophrenia.
Vikram Sachdeva said she had been detained under mental health legislation in November. He said it was not a case about "foisting a Caesarean section on a unwilling patient" but a case about what was in the woman's best medical interests. Unfortunately she has very severe mental health difficulties," he said.
"None of (the psychiatrists) see her being capable of using or weighing up information about whether to have a Caesarean section, even if it is necessary to save her life."
The lawyer representing the woman said doctors were seeking the "least restrictive option". And Justice Peter Jackson said he had concluded that allowing doctors to operate against the woman's wishes if necessary was in her best interests. "The proposal that the trust make offers the best chance for a secure labour and delivery," he said. "It will give her the chance of having a normal labour but will protect her safety."