Re S (Adult: Sterilisation)
| Jurisdiction | England & Wales |
| Judgment Date | 1999 |
| Date | 1999 |
| Year | 1999 |
| Court | Family Division |
Medical treatment – Adult – Sterilisation – Future risk of pregnancy – Whether court should authorise sterilisation.
S was 22 years’ old and a charming and attractive young woman and to all outward appearances entirely normal. However, her mental and emotional state was such that she was incapable of looking after herself, and she was thus vulnerable to sexual exploitation. Although nothing untoward had happened to S to date, her parents feared that at some unguarded moment in the future, some man would be able to contrive a situation in which S was subjected to sexual intercourse and might become pregnant. Accordingly, her mother applied to the court to declare that it would be lawful for S to be sterilised so as to completely eliminate of the risk of pregnancy.
Held – In determining whether to authorise the sterilisation of an adult woman incapable of giving her own consent, the assessment of future risk had to be based on circumstances as they presently existed or could be reasonably be foreseen to exist. In the absence of any risk that could be called identifiable rather than speculative, the court would not authorise such treatment. In the present case, there was no identifiable occasion when S had been at risk. Since in those circumstances were the court to declare sterilisation lawful, it was difficult to envisage any factual situation in which that relief would be refused, and it followed that the application would be dismissed.
Cases referred to in judgmentB (a minor) (wardship: sterilisation), Re [1988] AC 199, [1987] 2 All ER 206, [1987] 2 WLR 1213, HL.
D (a minor) (child in care: adoption), Re [1987] FCR 140, CA; affd sub nom Re KD (a minor) (ward: termination of access) [1988] FCR 657, [1988] AC 806, [1988] 1 All ER 577, [1988] 2 WLR 398, HL.
F (mental patient: sterilisation), Re [1990] 2 AC 1, CA; affd [1990] 2 AC 1 sub nom F v West Berkshire Health Authority (Mental Health Act Commission intervening) [1989] 2 All ER 545, [1989] 2 WLR 1025, HL.
LC (medical treatment: sterilisation), Re (1993) [1997] 2 FLR 258.
W (an adult: sterilization), Re[1993] 2 FCR 187.
Originating summonsThe mother of an adult, who was mentally and emotionally handicapped and thus vulnerable to sexual exploitation, applied to the High Court for a declaration that it would be lawful to sterilise her daughter in order to achieve complete elimination of
the risk of pregnancy. The case was heard and judgment was given in chambers. The case is reported with permission of Johnson J. The facts are set out in the judgment.
Jonathan Cole (instructed by Russell Steward, Norwich) for S.
Caroline Harry-Thomas (instructed by the Official Solicitor) for the Official Solicitor.
Cur adv vult
29 January 1998. The following judgment was delivered.
JOHNSON J.S is 22. She is a charming and attractive young woman and to all outward appearances entirely normal. However her mental and emotional state is such that she is quite unable to look after herself. She has virtually no ability to communicate except by making some very basic noises. She requires help in dressing and looking after her own basic physical needs. She could not be left to walk alone along a street. She has no understanding of sexuality. In sum, she is vulnerable. In particular, in the world as unhappily it is, she is vulnerable to sexual exploitation.
So it is that her parents decided, and I emphasise after much thought, that it would be best for S if she were to be sterilised. In these proceedings, brought nominally in the name of S herself, her mother asks the court to declare that it would be lawful for the necessary medical procedures to be performed.
S’s parents have devoted themselves to her upbringing. They are caring, responsible parents, committed to the care of their child. There is no hint of any selfish motivation in the present application; their thought is only to do what is best for S. So far nothing untoward has happened to S but the anxiety is that at some unguarded moment in the future, some man will be able to contrive a situation in which S is subjected to sexual intercourse and may become pregnant. S has no appreciation of what is involved in the sexual act, in pregnancy or in child birth. There could never be any question of S being able to keep a child were it born to her, even with the most enormous support. This case is all about future risk. There is no question here of any infringement of S’s right to reproduce. As Lord Oliver said in Re B (a minor) (wardship: sterilisation) [1988] AC 199 at 211, [1987] 2 All ER 206 at 219:
‘. . . the right to reproduce is of value only if accompanied by the ability to make a choice.’
In the words of Lord Hailsham ([1988] AC 199...
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Practice Note (Official Solicitor: Declaratory Proceedings)
...(Sterilisation) [1997] 2 FLR 258. Any risk of pregnancy should be identifiable rather than speculative: Re S (adult: sterilisation) [1999] 1 FCR 277; sub nom Re S (Medical Treatment: Adult Sterilisation) [1998] 1 FLR 944. (2) Damage deriving from conception and/or menstruation The physical ......
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Re S (Sterilisation: Patient's Best Interests)
...Health Authority (Mental Health Act Commission intervening) [1989] 2 All ER 545, [1989] 2 WLR 1025, HL. S (adult: sterilisation), Re[1999] 1 FCR 277. ApplicationThe parents of a 31-year-old woman, who suffered from severe mental retardation, applied to the High Court, supported by the Offic......