Gloucestershire Hospitals NHS Foundation Trust & Anor v Joanna [2023] EWCOP 21

Application for declaration that Joanna lacks capacity to decide about her obstetric care and to litigate and about her best interests.

Joanna, not her real name, was 38 weeks pregnant at the time of the application and had been detained under s3 of the MHA at another hospital since March 2023. She has a diagnosis of first episode psychosis that could become a formal diagnosis of schizophrenia: there is a family history of psychosis. 

In this judgment, published to reassure Joanna that the process was fair and transparent [3], Mostyn J agrees with the unanimous medical opinion that Joanna lacked capacity to decide on medical and states at [16] "logically, it would be vanishingly unlikely she would be able to formulate and make submissions to a judge in relation to that decision making process" so she also lacked capacity to litigate. As for her best interests, he decides at [21] that

"A caesarean section accords with Joanna's expressed wishes as to the mode of her child's delivery, albeit the reasons she has expressed for this preference are not well-founded and do not need to be stated in this public judgment. It is my judgment that her wishes have nonetheless been expressed clearly and that they should be afforded due respect."

He therefore makes the declaration sought, stating it is in Joanna's best interests to have a planned caesarean section.

Read the judgment on Bailii