The Illusion of Choice—Have Enforced Caesarean Cases Introduced a New Class of Incompetent Adults?

Authors: Mabel Wei Published date: 15-01-2016 Status: Published

In Norfolk and Norwich Healthcare NHS Trust v W1, Justice Johnson found a mother incompetent to refuse a caesarean section despite not suffering from any mental disability because, as a result of “acute emotional stress and physical pain in the ordinary course of labour”2, he believed that she was not able to weigh up the information presented to her. On that very same day, Johnson J similarly decided in Rochdale Healthcare NHS Trust v C3 that the mother was not capable of weighing the information given to her because she “was in the throes of labour with all that is involved in terms of pain and emotional stress”4. Besides suggesting that the state of labour has a bearing on finding the patient incapable, Johnson J went further to assess the content of the patient’s refusal—that one who was able “to accept the inevitability of her own death” was evidence of someone who was incapable of weighing up the information, therefore her refusal of a caesarean section that could potentially save her life would be invalid.5 These two cases illustrate the creation of a catch-22 situation, whereby if a competent mother exercises her discretion to refuse medical intervention, the psychiatrist and judge would consider the mother incompetent by virtue of that very decision. The corollary is that “women in labour may only have the capacity to withhold consent as long as they do not”.6 Such an illusion of autonomy demonstrates how pregnant women have implicitly been newly classed as incompetent adults. Keywords: Enforced caesarean section, patient autonomy, right to life, incompetent adult, consent, Mental Capacity Act 2005

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COPYRIGHT: © The UK Law and Society Association, 2016