Norfolk and Norwich Healthcare (NHS) Trust v W
| Jurisdiction | England & Wales |
| Judgment Date | 1996 |
| Date | 1996 |
| Court | Family Division |
JOHNSON, J
Medical treatment – patient in labour – denying pregnancy – forceps delivery and possible Caesarian section necessary – patient not suffering from mental illness but not capable of understanding information about proposed treatment – whether court had common law power to authorize treatment.
The patient arrived at hospital in the last stages of pregnancy. She was fully dilated and ready to deliver her baby but was in a state of arrested labour. However, she denied that she was even pregnant. She had a history of psychiatric treatment and had had three previous pregnancies all terminating by Caesarian section. It was necessary to take action. The consultant obstetrician sought authority to bring the patient's labour to an end by way of forceps delivery and, if necessary, by Caesarian section. If this action was not taken there were two risks to the patient: first that if the foetus was not delivered it would suffocate within the patient which would have life-threatening consequences for the health of the patient; and second that the patient's old Caesarian scars would reopen with a consequent risk to the life of the foetus and the health of the patient. A consultant psychiatrist interviewed the patient. In his opinion she was not suffering from a mental disorder but he was unable to say whether she was capable of comprehending and retaining information about the proposed treatment nor whether she was capable of believing information given to her about the treatment. However, he was of opinion that she was not able to balance the information given to her.
Held – Although the patient was not suffering from a mental disorder she lacked the mental competence to make a decision about the treatment that was proposed because she was incapable of weighing up the considerations that were involved. Termination of labour would be in the best interests of the patient. It would end the stress and the pain of her labour, it would avoid the likelihood of damage to her physical health which might have potentially life-threatening consequences, and it would avoid her having any feeling of guilt were she, by her refusal to consent, to cause the death of the foetus. The situation was one where there was a necessity to act and the action taken would be that which a reasonable person would take acting in the best interests of the assisted person. In the circumstances the court had power at common law to authorize treatment.
Statutory provisions referred to:Mental Health Act 1963, s 63.
Cases referred to in judgment:F (Mental Patient: Sterilization), Re...
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