Judge orders mentally ill woman to have forced caesarean
By Patrick Sawer
A High Court judge has given doctors permission to perform an urgent caesarean section on a mentally-ill woman with diabetes.
The woman was delivered of a baby boy within hours of Mr Justice Hayden giving specialists at the Royal Free London NHS Trust approval for the procedure, following a five-hour hearing at the Court of Protection.
He conceded that the decision was “draconian” but insisted it was necessary because the 32-year-old mother’s life may be in danger.
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.
Lawyers representing the trust said that the baby had been delivered without problem in the early hours of Saturday, and that the woman had hugged a surgeon after recovering consciousness. They said no restraint had been necessary.
The case has echoes of the treatment of Allesandra Pacchieri, an Italian woman forced to have her baby delivered by c-section and then removed from her by Essex social services, and comes at a time when the operations of the Court of Protection, which deals with such issues, is under renewed scrutiny.
The woman, who had been 32 weeks pregnant, was deemed unable to make the decision over how to give birth.
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”.
Mr Justice Hayden heard how she was thought to have paranoid schizophrenia, had stopped eating and tried to kill herself.
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 judge ruled that neither the woman nor the hospital where she was treated should be named but the health authority should be 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.”
Mr Justice Hayden concluded that the woman lacked the mental capacity to regulate her diabetic medicine and monitor her own intake of food and water.
However, 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.
The Telegraph revealed in December how Miss Pacchieri, an Italian who suffers from a bipolar condition, was taken into hospital while visiting England and sectioned under the Mental Health Act.
In a hearing which took place behind closed doors at the secretive Court of Protection, a judge granted permission for doctors to forcibly remove her unborn child, a girl, who was put into foster care almost immediately.
Miss Pacchieri, 35, is fighting to get her daughter back and a decision on her case will now be taken by Sir James Munby, Britain’s most senior family judge.
The child, now 15 months old, can only be referred to as Child P because her anonymity is protected by court orders. She is still in the process of being adopted, against her mother’s wishes.
Miss Pacchieri came to Britain in June 2012 for a training course at Stansted airport to become an air hostess, when she suffered what her legal team insist was a “panic attack” which led to her being sectioned.
She said she had rung police for help who, after speaking to her mother in Italy about her bipolar condition, took her from her hotel to hospital, where she was told she would be sectioned.
She claims she refused to take medication for her condition because she feared it would harm her unborn child.
Ten weeks later, in August 2012, the local health authority obtained an order enabling doctors to deliver the child by caesarean section while Essex County Council began care proceedings which led to the girl being eventually put up for adoption.
By Patrick Sawer
A High Court judge has given doctors permission to perform an urgent caesarean section on a mentally-ill woman with diabetes.
The woman was delivered of a baby boy within hours of Mr Justice Hayden giving specialists at the Royal Free London NHS Trust approval for the procedure, following a five-hour hearing at the Court of Protection.
He conceded that the decision was “draconian” but insisted it was necessary because the 32-year-old mother’s life may be in danger.
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.
Lawyers representing the trust said that the baby had been delivered without problem in the early hours of Saturday, and that the woman had hugged a surgeon after recovering consciousness. They said no restraint had been necessary.
The case has echoes of the treatment of Allesandra Pacchieri, an Italian woman forced to have her baby delivered by c-section and then removed from her by Essex social services, and comes at a time when the operations of the Court of Protection, which deals with such issues, is under renewed scrutiny.
The woman, who had been 32 weeks pregnant, was deemed unable to make the decision over how to give birth.
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”.
Mr Justice Hayden heard how she was thought to have paranoid schizophrenia, had stopped eating and tried to kill herself.
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 judge ruled that neither the woman nor the hospital where she was treated should be named but the health authority should be 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.”
Mr Justice Hayden concluded that the woman lacked the mental capacity to regulate her diabetic medicine and monitor her own intake of food and water.
However, 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.
The Telegraph revealed in December how Miss Pacchieri, an Italian who suffers from a bipolar condition, was taken into hospital while visiting England and sectioned under the Mental Health Act.
In a hearing which took place behind closed doors at the secretive Court of Protection, a judge granted permission for doctors to forcibly remove her unborn child, a girl, who was put into foster care almost immediately.
Miss Pacchieri, 35, is fighting to get her daughter back and a decision on her case will now be taken by Sir James Munby, Britain’s most senior family judge.
The child, now 15 months old, can only be referred to as Child P because her anonymity is protected by court orders. She is still in the process of being adopted, against her mother’s wishes.
Miss Pacchieri came to Britain in June 2012 for a training course at Stansted airport to become an air hostess, when she suffered what her legal team insist was a “panic attack” which led to her being sectioned.
She said she had rung police for help who, after speaking to her mother in Italy about her bipolar condition, took her from her hotel to hospital, where she was told she would be sectioned.
She claims she refused to take medication for her condition because she feared it would harm her unborn child.
Ten weeks later, in August 2012, the local health authority obtained an order enabling doctors to deliver the child by caesarean section while Essex County Council began care proceedings which led to the girl being eventually put up for adoption.