Re MB (Medical Treatment)
A competent pregnant woman may refuse a caesarean section even if her decision may lead to the death of her unborn child, but a phobia of needles may temporarily deprive a person of capacity.
Facts
MB, who was pregnant, agreed to a caesarean section because the baby was in a breech position, but she had a phobia of needles, and refused to allow the anaesthetic to be administered by injection. The hospital applied for a declaration that it would be lawful to carry out the caesarean section, using anaesthesia, without her consent. The judge granted the declaration, and MB appealed, although the baby had by then been born safely.
Legal principle
The Court of Appeal upheld the declaration, but on the basis that MB lacked capacity at the time. Butler-Sloss LJ said that every person is presumed to have capacity, and that a competent woman may, for religious reasons, other reasons, for rational or irrational reasons or for no reason at all, choose not to have medical intervention, even though the consequence may be the death or serious handicap of the child she bears, or her own death. However, a person lacks capacity if she is unable to comprehend and retain the information or to use it and weigh it in the balance, and a temporary factor such as panic induced by fear may destroy capacity. MB's needle phobia had overwhelmed her ability to make a decision at the critical time.
Related cases on consent, capacity and refusal of treatment
- Re B (Adult: Refusal of Medical Treatment) [2002] EWHC 429 (Fam)
- Re C (Adult: Refusal of Treatment) [1994] 1 WLR 290
- F v West Berkshire Health Authority (Re F (Mental Patient: Sterilisation)) [1990] 2 AC 1
- P v Cheshire West and Chester Council [2014] UKSC 19, [2014] AC 896
- R v Bournewood Community and Mental Health NHS Trust, ex p L [1999] 1 AC 458
- St George's Healthcare NHS Trust v S [1999] Fam 26
- Re T (Adult: Refusal of Treatment) [1993] Fam 95
- Wye Valley NHS Trust v B [2015] EWHC 60 (COP)
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