Page last updated at 12:34 GMT, Thursday, 27 May 2010 13:34 UK

Hospital phobia woman ordered to have surgery

Hospital corridor
The woman has failed or refused to attend hospital for treatment

A cancer patient who has a phobia of hospitals should be forced to undergo a life-saving operation if necessary, a High Court judge has ruled.

Sir Nicholas Wall, sitting at the Court of Protection, ruled doctors could forcibly sedate the 55-year-old woman, who has learning difficulties.

The woman lacked the capacity to make decisions about her health, he said.

Doctors at her NHS foundation trust had argued she would die if her ovaries and fallopian tubes were not removed.

Evidence presented to Sir Nicholas, head of the High Court Family Division, said the woman - referred to as "PS" - was diagnosed with uterine cancer last year.

'Entirely right'

It was slow growing but would, without surgery, ultimately spread and kill her, he heard.

The woman, who is said to have a "significant impairment in intellectual functioning", has failed or refused to attend hospital for treatment. She has a needle phobia as well as a hospital phobia.

In his ruling, Sir Nicholas said if persuasion failed, doctors could sedate PS in order to get her to hospital - and to detain her there while she recovered after the operation.

He said he was "entirely satisfied" that it was "right to make the declarations sought by the trust".

Everything has to be tried to enable the person to make the choice themselves - for example putting information in the most straightforward form, perhaps with pictures, or telling them with the help of the person who knows the patient best
Liz Sayce
Chief executive of Radar

"Although the application is unusual and may involve the use of force, I am nonetheless impressed by the care and thought which have gone into ensuring that PS receives the treatment which she plainly needs and which it is plainly in her interests to have," he said.

David Congdon, head of campaigns at learning disability charity Mencap, said it was "right" for the courts to decide what was in the best interests of PS because "the patient clearly lacked the mental capacity to make the decision herself".

"This is an unusual case and we are very encouraged that health professionals have taken the right steps to ensure the patient receives the treatment she needs," he added.

Liz Sayce, chief executive of Radar, the disability network, said it was "positive" PS was getting life-saving treatment, because the most common problem people with learning difficulties had with healthcare was "not getting the treatment they needed... because some lives seem to be worth more than others".

But she said force was only justified if it was established, beyond doubt, that the patient could not comprehend that without it they would die.

"Everything has to be tried to enable the person to make the choice themselves - for example putting information in the most straightforward form, perhaps with pictures, or telling them with the help of the person who knows the patient best," she said.

The Court of Protection usually sits in secret, but Sir Nicholas said he made the ruling public to help others "who may be faced with a similar dilemma".



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