Letter: Ms S: the need for help and sympathy

Sir: The purpose of the Mental Health Act is the compulsory treatment of mental disorder.

To what extent can a Caesarean section be considered treatment for a mental disorder? In the case of Tameside and Glossop Acute Services Trust vs CH, 22 January 1996, Mr Justice Wall confirmed that, on the particular facts, a Caesarean section was treatment for the mental disorder suffered and could, therefore, be carried out without the consent of the patient, under the statutory authority of section 63.

This approach can be contrasted with the case of C, who was detained under the Mental Health Act suffering from schizophrenia, but who was entitled to withhold consent to an operation to amputate his gangrenous leg. In that case there was deemed to be no connection between the mental disorder suffered and the physical disorder of gangrene and the court upheld the patient's right to make a decision which might lead to his death.

Your article is right to question whether refusing treatment in these circumstances is evidence of mental disorder; equally worrying from a civil rights perspective is whether the treatment authorised by section 63 of the Mental Health Act can consist of intervention of what appears to be a purely physical nature.

STEPHEN JONES

Senior Lecturer

Liverpool John Moores University