Cardiff and Vale University Health Board v NN
[2024] EWCOP 61 (T3)
H (An Adult; Termination), Re
24 October 2023
[2023] EWCOP 183
Court of Protection
A woman with mental health issues wants an abortion but doctors aren't sure she understands what she's choosing. The judge decided she can't make the choice herself, and an abortion is best for her safety, but only if done with medication. The judge also said the woman shouldn't be forced, except maybe for a quick check to make sure everything is alright.
Key Facts
- •Ms H, a 26-year-old woman with schizoaffective disorder, is detained under the Mental Health Act 1983.
- •She is 17 weeks pregnant and wishes to terminate the pregnancy.
- •The applicants (two NHS Trusts) argue she lacks capacity to consent to a termination and seek a court order.
- •The Official Solicitor acts as Ms H's litigation friend.
- •The court considers whether Ms H has capacity, whether termination is in her best interests, and the method of termination (medical or surgical).
- •A remote judicial visit with Ms H was conducted.
- •Expert psychiatric and obstetric evidence was presented.
Legal Principles
Mental Capacity Act 2005 (MCA)
Mental Capacity Act 2005
Abortion Act 1967
Abortion Act 1967
Best interests
Aintree University Hospitals NHS Foundation Trust v James [2013] UKSC 67
Capacity
A Local Authority v JB [2021] UKSC 52; North Bristol NHS Trust v R [2023] EWCOP 5
Human Rights Act 1998
Human Rights Act 1998
Weight attached to wishes and feelings of incapacitated person
Re AB (Termination of Pregnancy) [2019] EWCA Civ 1215; ITW v Z And others [2011] WLR 344
Outcomes
Ms H lacks capacity to conduct the proceedings and to decide whether to terminate her pregnancy.
Her schizoaffective disorder impairs her ability to understand, weigh, and use relevant information.
A medical termination is in Ms H's best interests.
This balances her strong wish for a termination, the significant mental health risks of continuing the pregnancy, and the manageable physical risks of a medical termination. The risk of suicide if forced to undergo a surgical termination is a decisive factor.
Covert medication is authorized.
To help manage Ms H's discomfort and anxiety during the termination.
Restraint is authorized only in limited circumstances.
If necessary to conduct a vaginal examination to ensure Ms H's safety after a medical termination has begun but is incomplete.