Sunday, February 24, 2013

parents of woman with down syndrome, 21, cannot have her sterilized, rules judge

by Daniel Miller from the Daily Mail (UK):
The parents of an 'affectionate' 21-year-old woman with Down's syndrome have been forbidden from having her sterilised despite their concerns she could fall pregnant.In a landmark ruling at the Court of Protection in London, Mr Justice Cobb concluded that such a procedure would be 'disproportionate'.He said the case engaged important human rights considerations and that  the woman, referred to as K, lacked the capacity to understand and weigh up the options for herself. The parents feared their daughter, who does not have a boyfriend and had expressed no interest in having one, could easily be taken advantage of. But Mr Justice Cobb said there were less restrictive methods of 'achieving the purpose of contraception' which should be tried first.
He added it was in the woman's best interests that he should 'bring as much clarity to medical treatment issues' as he could.
He wrote in a statement: 'The issue which divides the parties is whether I should declare in these proceedings at this stage that it is not in the woman's best interests to be the subject of a sterilisation procedure'.
'No-one can doubt the seriousness and significance of a sterilisation procedure. Further surgery would be required to reverse it, and then only with a moderate prospect of success.'
Mr Justice Cobb said the woman was part of a 'loving' and 'supportive' family and said he had read 'nothing but praise' for her parents.
The parents, referred to in court as Mr and Mrs K, had gone to see a specialist who had originally supported the idea of sterilisation but a second expert had suggested other forms of contraception.
The judge added: 'Although Mr and Mrs K expressed concerns that K is occasionally 'tactile' and 'overfamiliar', that she has begun to be more aware of the 'opposite sex', and is vulnerable to sexual exploitation.
'I note that K is well-supervised at home and at college; there is no evidence she is seeking a sexual relationship.'
The judge said the local authority had begun proceedings in the Court of Protection, which is part of the High Court and analyses issues surrounding the care and treatment of sick and vulnerable people.
He said he had made a declaration under the provisions of mental capacity legislation after the woman's parents disagreed with a local authority - and medics - about the best way 'to achieve contraception'.
He added: 'I have sought to achieve the right balance between protection and empowerment.
'It is my judgment that sterilisation would be a disproportionate (and not the least restrictive step) to achieve contraception for the woman in the future.'
The judge said risk management was 'plainly' better than invasive treatment and less restrictive.
Mr Justice Cobb added: 'It is in the woman's best interests that I should make this declaration now; I do not believe that it is in her best interests that this issue should be left unresolved.'
And the judge said the woman's parents had concerns about how pregnancy would affect their daughter.
'Have become increasingly concerned that as K becomes older their ability to control and supervise aspects of her life will be reduced,' he added.
'Were she to become pregnant at any time in the future they believe this would have a seriously adverse effect upon her.'

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