H (An Adult; Termination), Re
[2023] EWCOP 183
Cardiff and Vale University Health Board v NN
30 October 2024
[2024] EWCOP 61 (T3)
Court of Protection
A woman in a mental health hospital wanted an abortion but couldn't decide herself. The hospital waited too long to ask the court for permission, so the court made them pay extra. The woman got the abortion okay in the end.
Key Facts
- •NN, a 32-year-old woman with schizophrenia and a history of substance abuse, was detained under the Mental Health Act 1983.
- •NN was approximately 18 weeks pregnant and expressed inconsistent wishes regarding termination.
- •The Cardiff and Vale University Health Board sought a court order declaring it lawful and in NN's best interests to be offered a termination, acknowledging potential need for restraint/sedation.
- •The court found NN lacked capacity to decide on termination.
- •The court authorized aspects of the treatment plan involving potential deprivation of NN's liberty if she chose termination and later refused medical intervention.
- •NN underwent a medical termination without the need for restraint.
- •The Official Solicitor claimed the Health Board unreasonably delayed issuing proceedings.
Legal Principles
Best interests of a person lacking capacity
Mental Capacity Act 2005 (MCA)
Deprivation of liberty under Article 5 ECHR
European Convention on Human Rights (ECHR)
Lawfulness of abortion
Abortion Act 1967
Costs in Court of Protection proceedings
Mental Capacity Act 2005, Court of Protection Rules 2017
Deprivation of liberty and MHA detention
Case law
Doctrine of necessity
Case law
Section 4B MCA 2005
Mental Capacity Act 2005
Outcomes
Declaration that NN lacked capacity to decide on termination.
Evidence from psychiatrists and obstetrician indicated NN lacked understanding of the procedure and its implications.
Authorization of aspects of treatment plan related to potential deprivation of liberty.
To protect NN's health if she chose termination and later refused necessary medical intervention.
Health Board to pay 100% of Official Solicitor's costs (excluding costs from initial hearing).
Unreasonable delay in issuing proceedings caused by the Health Board negatively impacted NN.