High Court for a declaration to the effect that it would be lawful to undertake
treatment ,including a caesarean section. Meanwhile S had been in touch with
solicitors with the intention of making an application to a Mental Health Review
Tribunal. The declaration was granted. It appears that the judge was under an
incorrect impression that S had been in labour for 24 hours. S gave birth to a
daughter. The detention under the Mental Health Act was terminated. S discharged
herself. While detained in hospital S was not offered treatment for her mental
disorder. An action was subsequently brought for judicial review to challenge the
legality of the action taken.
The Court of Appeal again emphasised the fact that the competent adult is
entitled to refuse treatment [48]. Lord Justice Judge stated that:
`In our judgment while pregnancy increases the personal responsibilities of a
woman it does not diminish her entitlement to decide whether or not to undergo
medical treatment. Although human and protected by the law in a number of
different ways as set out in the judgment inIn re MB...an unborn child is not a
separate person from its mother. Its need for medical assistance does not prevail
over her rights.'These words are indicative of the tensions in drawing the boundaries between
moral acceptability and legal enforcement in this area [50]. While some may regard
apregnant woman as possessing moral responsibilities to the fetus in the latter
stages of pregnancy ,this still does not limit her legal rights. The orthodoxy ofPaton
and subsequent cases was again confirmed by the court.
The court held that a battery had been committed on S. Lord Justice Judge stated
that:
`... how can an enforced invasion of a competent adult's body against her will
even for the most laudable of motives ?the preservation of life) be ordered
without irredeemably damaging the principle of self-determination.' [51]The court examined the provisions of section 2?2) which provide that:
`An application for admission for assessment may be made in respect of a patient
on the grounds that
?a) he is suffering from a mental disorder of a nature or degree which warrants
the detention of the patient in a hospital for assessment ?or for assessment
followed by medical treatment) for at least a limited period; and
?b) he ought to be so detained in the interests of his own health and safety or
with a view to the protection of other persons.'The Court of Appeal emphasised that the criteria for detention under the section
were cumulative. In this case the doctors had been justified in their assessment
that the woman was suffering from depression which constituted `mental
disorder'. However ,S was not being detained in order that treatment be given for
her mental disorder. It was stated that:
`For the purposes of section 2?2)A such detention must be related to or linked
with the mental disorder. Treatment for the effects of pregnancy does not pro-
vide the necessary warrant.'110 Nursing Law and Ethics