University Hospitals of Derby And Burton NHS Foundation Trust v J (Medical Treatment: Best Interests)  EWCOP 16
Application brought by the University Hospitals of Derby and Burton NHS Foundation Trust for declarations that it is in the P's best interests to undergo a hysterectomy and bilateral salpingo-oophorectomy (HBSO) and a colonoscopy, and that, in order to enable those to be undertaken, it is in her best interests for a transfer plan to be implemented which will involve her sedation and a level of deception to ensure her presence at hospital for the procedures to be undertaken. Application granted.
The P, a young woman, has a diagnosis of autistic spectrum disorder and a severe learning disability. At times her behaviour can be very challenging. Since she started menstruating as a teenager her monthly cycle has affected her behaviour and mood, which has in turn restricted her lifestyle. She is very upset at the sight of blood, and her distress manifests itself in various forms. In addition, the hormonal changes (linked to the production of progesterone) prompt an increase in her aggressive and challenging behaviour. The P was having monthly injections of Decapeptyl which suppresses normal hormonal activity including menstruation but this is not an appropriate long term solution. A hysterectomy is the last realistic option given that Decapeptyl injections cannot be used long-term. Both the Official Solicitor and the P's parents agreed that the P lacks capacity, and that it was in her best interests for the treatment to be undertaken and for the care plan to be implemented.
The court allowed the application. The overall balance in the evaluation of the P's best interests was overwhelmingly in favour of the proposed HBSO, the colonoscopy and the care plan which will facilitate those surgical procedures being undertaken.
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