The Court of Protection has ruled that a "delightful, warm, engaging and affectionate" 21-year-old woman with Down’s syndrome should not be sterilised, despite her parents’ fears that she could be taken advantage of and become pregnant.
The woman, named only as K, a student at a college for individuals with learning disabilities, had initially had a hormonal contraceptive implant inserted in her arm by her GP but it was removed after causing adverse side effects. Her parents then endeavoured to arrange sterilisation, for their daughter’s future protection, in light of fears arising from her increasing awareness of the opposite sex and naivety in dealing with others. They believe that pregnancy would have a seriously adverse effect upon her.
Mr Justice Cobb, however, ruled that it would be disproportionate and unnecessary to perform the invasive and risk-laden procedure. He took into account the family’s concerns, K’s current situation (which involved working with the community learning disability nurse to assist her to reduce her vulnerability around others) and an expert report concluding that there was no clinical need for sterilisation and that it was not in K’s best interests, given that she showed no immediate signs of forming a relationship. Other forms of contraception could be considered should the need arise, the court observed, these being less restrictive methods of offering K the protection sought.
Cases where sterilisation of individuals who lack capacity to consent to the operation is sought are very fact specific and, in considering what is in a particular individual’s best interests, the court will take great care to decide how best to afford protection to a vulnerable member of society without encroaching unduly on their personal liberty and right not to be subjected to risky medical procedures to which they lack capacity to consent.