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(Court of Protection, Holman J, 15 October 2012)
The 61-year-old woman suffered from a psychotic disorder and a form of chronic schizophrenia. She had cancer of the uterus which with a potentially life-saving operation could be cured. However, due to other medical factors there was a considerable risk that she could die either during the operation or in the post-operative recovery period. All parties were in agreement that the woman lacked capacity to make informed decisions about major medical treatment. The woman's three adult sons all believed the operation was in her best interests but the Official Solicitor acting as her litigation friend considered that it was too risky.
A prior attempt to perform the operation had been made but upon learning of the procedure at the hospital the woman became so agitated and resistant that it had to be abandoned. One of the woman's medical issues was a heart abnormality which could result in sudden death if she became agitated for example by use of physical restraint. While it was clear that the woman needed to be informed prior to the operation the question arose whether she could be mildly sedated before she was told to prevent her reacting so.
On all the available evidence, the risk of post-operative mortality was high but it was not so high as the assessment and position of the Official Solicitor assumed.
It was in the best interests of the woman to have the surgery. The court ordered it would be lawful for the medical procedures to be carried out notwithstanding the woman's lack of consent. However, right up until the last moment it would be a matter for the individual professional judgment of the treating clinicians as to whether they thought it justifiable to embark up on the sedation, the anaesthesia and the surgery.
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