Macdonald J gives judgment on an out of hours application in which a health trust sought authority to remove a woman, who was in obstructed labour, from her home to hospital to deliver the baby there, including an emergency Caesarean operation if necessary. He granted the application.
The judge agreed with Keehan J in in An NHS Trust and Anor v FG (By Her Litigation Friend, the Official Solicitor) [2014] EWCOP 30 about the duty on health trusts to plan so as to avoid out of hours applications. However, he accepted that the circumstances had arisen in such a way that this was an appropriate case for an out of hours application.
GH had suffered from depression, anxiety and agoraphobia. The effect of the agoraphobia was such that she had not left home since 2017. She had wanted to have a home birth, regarding her home as a safe space. She had however said that she would go to hospital if necessary. However, as her labour did not progress as planned she was warned by the midwives attending her at home of the serious risks to her baby’s and her own health. She declined the advice to go to hospital on the basis that being in her "safe space" protected her from the risks. Her capacity was re-assessed, and the assessor concluded that GH was unable to use and weigh the information about risk of harm. The judge agreed. He concluded that it was not a case where GH acknowledged the information of the risks but preferred her own beliefs about risk, instead the anxiety and agoraphobia prevented her using and weighing up the information about risk. He concluded that she had ceased to have capacity.
In deciding on her best interests, having balanced the risks of increased anxiety and restraint when GH is already stressed with the risks of not taking the requested steps. The judge also took into account her previous expressed willingness to go to hospital and her established view that she wanted herself and the baby to remain alive and healthy. The judge noted that her partner and family wanted her to go to hospital.
He also authorised the use of restraint and reasonable force. agreed with the Official Solicitor that the use of mild sedation should be considered in effecting the removal from home and what is reasonable should take into account medical advice on her condition at […]
