Learning Disability Today
Supporting professionals working in learning disability and autism services

High Court rules that man with learning disabilities can be sterilised

gavelThe High Court has ruled that a man with learning disabilities can be sterilised because it is “in his best interests” – a legal first.

The man, known only as DE for legal reasons, who is 36, has a learning disability and lives with his parents. He is already a father after his long-term girlfriend, known only as PQ and who also has learning disabilities, gave birth in 2010.

But DE has since expressed a wish to not have any more children. Additionally, DE could not be relied upon to use contraception effectively on a consistent basis, meaning his girlfriend could still potentially conceive.

The judge, Mrs Justice Eleanor King, ruled that DE does not have capacity to make a decision on whether or not to undergo a vasectomy and to consent to this procedure. She added that it is lawful and in DE’s best interests that he should undergo a vasectomy and all “reasonable and proportionate steps” should be taken to enable the operation to go ahead.

Mrs Justice King found that in the event of a further pregnancy there would undoubtedly be further and probably more serious psychological distress and consequences for DE.

The application came to court because of undisputed evidence that, while DE was in favour of having a vasectomy, he did not have the capacity to consent to the procedure, meaning the judge had to decide. The application was made by the man’s local NHS trust, with the support of his parents, GP and the local authority involved in his care. None of them must be identified, by court order.

DE’s learning disability means that he could not live on his own, cannot use money, has limited speech and is dependent on his parents to provide him with significant support both practical and emotional.

The court also heard how the consequences of the first pregnancy were profound for the families of DE and PQ.

For instance, concerns that DE may not have capacity to consent to sexual relations meant that protective measures had to be put in place to ensure that DE and PQ were not alone and DE became supervised at all times. DE was clear that he did not want any more children. His relationship nearly broke under the strain but they have stayed together. 

Beverley Dawkins, policy manager at learning disability charity Mencap, said: “This case was rightly referred to the Court of Protection, as sterilisation is such a serious medical intervention and impacts on fundamental human rights. Decisions in such a case must always be about the specific circumstances of the individual and it’s important that every alternative is considered, to ensure the least restrictive option is chosen. The Court seems to have carefully weighed up what is in the best interests of this man, and reached a balanced decision that allows him to continue a loving relationship with his partner.

“We welcome the emphasis placed on the fact that this is an exceptional case and should not be seen as a green light for other applications for sterilisation in respect of people with a learning disability.” 

The full judgement can be read here: http://www.judiciary.gov.uk/Resources/JCO/Documents/Judgments/de-judgment-16082013.pdf

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