The Court of Protection has granted permission for doctors to perform potentially life-saving cancer surgery on a woman who has a ‘delusional belief’ that she does not have the disease. A judge ruled that the treatment would be lawful and in the best interests of the 61-year-old, who suffers from chronic schizophrenia.
Announcing his decision, Mr Justice Holman said: ‘She has cancer of the uterus. She could be cured by a potentially life-saving operation. However, because of other co-morbidities and other factors, there is a considerable risk that she could die during the operation or in the post-operative recovery period.
‘She herself lacks the capacity to make an informed decision. She denies that she has cancer at all and opposes, and is resistant to, the operation. The lady’s three adult sons all strongly desire that she should have the operation and feel that the potential benefits outweigh the risks. Everyone in this case is strongly motivated by a desire to prolong and maximise her life.’
The judge was ruling on an application brought under the Mental Capacity Act 2005 by an NHS trust in the south of England, which is responsible for the woman’s physical health care, for declarations setting out what treatment would be lawful in the circumstances of her case.
As well as her severe mental disorder, the woman is obese and suffers from diabetes. Observing that the woman is likely to die if her cancer goes un-treated, the judge stressed: ‘No-one, or any court, can order or require any doctor to take any step. The court can only permit it.’
The judge granted declarations to the trust that the proposed surgery under general anaesthetic would be lawful notwithstanding the woman’s refusal to consent to such treatment. It would also be lawful for sedation to be administered.
He concluded: ‘Assuming that the surgery takes place, it is of course my fervent hope that it proceeds as smoothly as possible to a good outcome for this woman. Like her sons I fully appreciate that it may not. I, like they, have tried to do my very best for her.’