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In a truly exceptional case, the Court of Protection has authorised the involuntary sterilisation of a learning disabled mother of six children on grounds that she lacks the mental capacity to make her own decisions in respect of contraception and that a further pregnancy would put her life in jeopardy.
The woman had a very low IQ, probably suffered from an adjustment disorder due to sexual abuse she suffered as a child and had endured a tragic and complex obstetric history. She had neither the desire, nor the ability, to care for any of her children, whose ages ranged from six months to 12 years and all of whom had been placed with permanent substitute carers.
She had a history of concealing her pregnancies and giving birth to her children at home without medical assistance. Her most recent birth had been traumatic and complicated and both she and the child had been at risk. She was currently in a long-term relationship with a learning disabled man and both of them were highly resistant to any form of medical intervention.
In those circumstances, two NHS trusts and the relevant local authority applied to the Court for authority to arrange the woman’s permanent sterilisation. It was recognised on all sides that carrying out such a procedure against the woman’s will would be a step ‘of the utmost gravity’ and that it would impact on her personal autonomy, privacy, bodily integrity and reproductive rights.
The Court granted permission for a laporoscopic sterilisation to be performed and also authorised forced entry to the woman’s home and the use of restraint if that proved necessary in conveying her to hospital. The woman lacked the ability to make rational decisions for herself and medical experts were unanimous that a further pregnancy might well cause her death.