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Court of Protection: NHS Trust asks judge to rule on hysterectomy for woman with serious mental health condition


A woman with a serious mental health condition should undergo a hysterectomy after being handcuffed and escorted by four guards to the operating table, an NHS Trust told a High Court Judge on Monday.

The woman, who is in her thirties and for legal reasons can only be named as 'Ms I,' is being held in a secure mental health facility. She has been suffering from a significantly prolapsed uterus for the last six months.

Doctors believe that as well as causing her pain, it has further impacted on her mental state. Justice Peter Jackson, who heard the Court of Protection case in London's Royal Courts of Justice, said he understood that Ms I was happy to have the operation but that since she is “obviously quite seriously psychiatrically unwell” she cannot give consent.

The barrister for the NHS trust, Parishil Patel said that “because of her mental state in relation to the risk posed to others,” the trust propose that she is “escorted by four female escorts and she will be restrained at all times during transfer and when she's at the surgery, other than when she's unconscious during the operation.”

Speaking of Ms I's feelings about the procedure, Mr Patel said: “She wishes to have the operation because she is distressed by the uterus prolapse that's happening between her legs”. Despite Ms I's willingness to undergo the procedure, lawyers argued she should be given a general anaesthetic to protect her and those treating her from being harmed if she became distressed on the operating table.

Other conservative methods of treatment, such as using a vaginal pessary to block a prolapse, have failed and doctors at the hospital believe a hysterectomy is the only option. The Official Solicitor, acting on behalf of the patient, asked on Monday for more time to discover whether any less invasive procedures would solve the problem.

An operation has been booked for Thursday and the judge will decide on Wednesday whether it can go ahead.

In a move which will be welcomed by campaigners for transparency in the court, Justice Jackson criticised lawyers for making it difficult for journalists to report the case properly. The Court of Protection, which makes health and welfare decisions on behalf of those deemed to lack capacity, has faced fierce criticism for being too secretive.

Justice Jackson said lawyers should have sent out an order to the press ahead of the case detailing what reporting restrictions were being applied for to limit reporting. The hearing was in open court, due to the serious medical treatment proposed, but “The media should have been notified in the normal way in good time,” he said.