Woman who does not believe she has cancer can undergo operation
A schizophrenic woman who does not believe she has cancer can now undergo a risky operation against her wishes that could save her life, on the orders of a senior judge.
By Martin Beckford, Home Affairs Editor
3:17PM BST 15 Oct 2012
The mother-of-three was deemed to lack the capacity to make critical decisions about medical treatment herself, while even the lawyer appointed to represent her “best interests” said the procedure was too dangerous.
But because her three sons said they wanted her to live and doctors said the procedure was worth the risk, Mr Justice Holman agreed that she could have surgery before tumours spread.
Sitting in the Court of Protection, which has the power to order life or death treatment for people who lack mental capacity, the judge said: “Everyone in this case is strongly motivated by the desire to prolong and maximise her life.”
He said he was “deeply conscious of the risk of death in this case”, but because of the “love and concern” shown by the patient’s sons, he concluded: “It seems to me to be a risk worth taking.”
The judge said the decision was a “heavy burden” on him but insisted he had “tried to do my very best” for the woman, as had her sons.
“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.”
He also stressed: “No one, or any court, can order or require any doctor to take any step. The court can only permit it.”
It is not the first time that the Court of Protection has been asked by NHS trusts to consider if it is in an incapacitated patient’s “best interests” to undergo medical treatment against their wishes.
In the first known case two years ago, a judge ordered that a woman with cancer who had a phobia of hospitals could be forcibly sedated at her home so that she could be taken into theatre and operated on.
This summer another judge agreed, with the backing of the patient’s mother, that doctors could stop trying to treat a seriously ill man who physically resisted help from medics.
In the latest case, the court heard that the 61-year-old woman was suffering from a chronic and severe mental order. She also weighs some 20 stone, has asthma and diabetes, and has delusions that she is still a young woman.
The woman, who can only be named as Mrs K and who lives in the south of England, is suffering from endometrial cancer, which affects the lining of the womb.
She “utterly denies that she has cancer” according to the judge and has a “delusional belief that she does not have cancer at all”.
But doctors said if her disease goes untreated it could spread to her bowels and bladder. This would cause her “pain and indignity before death”.
The Official Solicitor appointed to protect her interests believed the planned hysterectomy – removal of the uterus – was “too risky” because it carried a 5 to 10 per cent chance she might die.
But doctors, and the woman’s grown-up sons, “strongly desire she should have the operation and say the potential benefit outweighs the risk”, and the judge sided with them.
He agreed the proposed surgery under general anaesthetic would be lawful “notwithstanding K’s refusal to consent to such treatment”.
Mr Justice Holman concluded: “Assuming the surgery takes place it is of course my fervent hope that it proceeds as smoothly as possible to a good outcome for Mrs K.
“Like her sons I fully appreciate that it may not. I, like they, have tried to do my very best for her.”