Cambridge University Hospitals NHS Foundation Trust v BF [2016] EWCOP 26 (18 May 2016)

Posted on Wednesday, June 22nd, 2016

This case looked at a 36 year old woman, known as BF, who suffered from paranoid schizophrenia and was currently detained in a mental health unit. She was advised to have a total abdominal hysterectomy due to the fear that she may have ovarian cancer. This surgery, however, meant that BF would not be able to have children in the future. BF consented to the surgery, which would be conducted by the trust, although she did express doubts over it as she wanted to have children in the future which this operation would prevent. During the administration of the anaesthetic before the surgery she suffered a psychotic episode and decided that she wanted to cancel it. This psychotic episode caused the trust to fear that BF did not have the capacity to consent to the surgery. The trust therefore decided to take legal proceedings to establish BF’s rights that she had in relation to her capacity to consent for the hysterectomy.

Her capacity to consent to the surgery was decided in a hearing which included evidence from different professionals including a psychiatrist, a gynaecological oncologist and a consultant.  The hearing looked at whether BF had enough capacity to make decisions regarding her surgery and if not whether it was in her best interest to undergo the medical treatment the trust sought to give her.

The judgement concluded that BF lacked the capacity to make the decision between certain infertility and a potential fatal diagnosis therefore the courts would have to make the choice for her. It was therefore decided that it would be in BF’s best interest to undergo the surgery to remove her cancer even though this would remove her ability to have children.

BF went in for surgery on May 2016 and during tests conducted beforehand it was discovered that there was a benign or borderline tumour with no evidence of macroscopic residual disease. These findings meant that the doctor could performed a left salingo-ophorectomy, omentectomy and appendicetomy instead of a total abdominal hysterectomy and therefore BF’s uterus, right fallopian tube and right ovary was saved thus preserving her ability to have children in the future.

The full judgment can be read here

Summary by Claire Richardson

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