East Lancashire Hospitals NHS Trust v GH [2021] EWCOP 18

Application by NHS Trust that the P be admitted to hospital, against her will, for obstetric treatment and a possible emergency caesarean section. The application was granted.

​The P suffers from anxiety, depression and acute agoraphobia and went into labour at home nearly 72 hours before this hearing but who had thereafter suffered an obstructed labour. The Trust made an application that she be given treatment and a possible emergency caesarean section in hospital. Whilst the P had not fully engaged with a programme of ante natal care and whilst she had decided to have a home birth, she had in fact agreed to be admitted to hospital should this be required. At the time she gave that agreement there were no concerns regarding her capacity to make decisions concerning her admission to hospital should this be clinically indicated during the course of her labour. However, by the time this application was made, she had changed her mind. The application was made because she, and her unborn baby, were in danger of suffering serious injury, possibly death, if clinicians were not able to treat her in hospital.

The court concluded that the P did not have capacity to make decisions regarding medical treatment. This was not a case in which she had acknowledged the risk of serious injury or death, weighed that risk and then rejected that risk it in favour of an unwise course of action but rather a case in which she simply did not acknowledge the risk of serious injury or death or accept that the risk of serious injury or death was relevant to her as long as she remained in her "safe space". This demonstrated that the P's agoraphobia and anxiety had overwhelmed her ability to use and weigh the information required to decide whether to agree to be admitted to hospital for obstetric treatment and a possible emergency caesarean section. Within this context, the P's inability to use and weight information was clearly the result of an impairment of, or a disturbance in the functioning of, the P's mind or brain. 

​Read the full text of the judgment on Bailii