A 34 year-old woman with mental health issues must have surgery, the Court of Protection has ruled.
The woman had been diagnosed with a learning disability, autism and “a schizophrenic illness” and was living at a secure, private hospital. In addition to her mental health difficulties, she was diagnosed with “a serious and life threatening [heart] condition”.
She had developed an aneurism (swelling) in her heart which was at a “high risk of rupture”. Should that happen, it would cause “sudden and immediate death with little or no opportunity for emergency surgery”. The doctors’ believed that the chances of such a rupture would increase the longer it goes untreated.
The woman, identified as ‘AB’ in the judgment, objected to the idea of surgery. She also expressed delusional views such as the belief that “her heart has been stolen by different people and she has been given a different heart”.
The local health board applied to the Court of Protection for a declaration that AB lacked the ability to make decisions about her healthcare. The Court is empowered to make such decisions by the Mental Capacity Act 2005.
Sitting at the Cardiff Civil and Family Court, Her Honour Judge Isabel Parry said that the medical evidence was “uncontroversial and powerful”. She said that surgery was the only viable option to prevent a rupture in AB’s heart and that “she is fortunate that this has not happened already”.
The judge said that while she recognised that imposing “unwanted surgical procedures on AB … undermines her personal autonomy over her own body”, such steps were in her best interest. Judge Parry concluded that AB lacked the capacity to make such a decision and declared it would be lawful for the surgery to take place.
To read A Local Health Board v AB in full, click here.