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Woman with learning difficulties will be forcibly checked for possible cancer, judge rules

Woman aged 53 is frightened of hospitals and will be sedated

A woman with severe learning difficulties who has refused to undergo medical examinations for a possible cancer of the uterus will be sedated and forcibly treated, a High Court judge ruled today.

Mr Justice Moylan took less than an hour to decide the case in the Court of Protection this morning. The woman, known only as K to protect her identity, is 53 and lives in a residential home the north west of England.

For the last year she has been suffering from abdominal pain and vaginal bleeding, which could be associated with cancer of the womb. In December, her GP found a lump which could be cancerous, and in recent months she has lost weight.

But the woman is so frightened of hospitals that when she was eventually persuaded to attend an appointment with a gynaecologist earlier this year, she refused to be examined.

Mr Justice Molyan said: "I'm satisfied by the evidence that K does lack capacity to take decisions about medical treatment."

He later added: "Though the risk of cancer is relatively low, it is still, in my assessment, a significant risk and recently K has lost weight, which could be a further indication of cancer.

"Having regard to the weight of the medical evidence which has been attained in the case, and is all to the same effect, I'm satisfied that it is in K's best interests for her to undergo the treatment proposed by the NHS trust as set out in the care plan and I make a declaration to that effect."

Ultrasound would normally be the first investigation of someone with her symptoms, but the judge accepted doctors' advice to go straight to a hysteroscopy - a more detailed but invasive examination - because her distress at hospitals would mean she needed to be under a general anaesthetic anyway.

Describing the difficulties hospitals had in treating her, Mr Justice Molyan said: "K was unwilling to undergo further treatment as she is reluctant to go to hospital with a long-standing fear of hospitals, but an appointment was made and she attended. Once in hospital she had to wait for her appointment which caused her to become anxious. The treating gynaecologist managed to persuade K to go to the examination room but she then declined to permit the examination."

The Official Solicitor, acting for the patient, agreed that it was in her best interests for the treatment to go ahead, even without her consent. Her brother was also supportive of the idea and offered to go with her to hospital.

The case was brought by her local NHS trust, who wanted to agree a way to go ahead with formal diagnostic examinations.

Aswini Weereratne, representing the Official Solicitor, said they did "not consider there are any less restrictive steps to facilitate" K's treatment.