Medical Treatment: Decisions and the Law

12. Pregnancy and Childbirth

Co-authored by Bridget Dolan QC and Sarah Simcock.

Contents

  • A Introduction  12.1
  • B The legal background  12.2
  • Patient and foetal rights in obstetrics 12.2
  • The caesarean section cases 12.4
  • The mentally competent adult patient: Re S (adult: refusal of treatment) 12.5
  • A solution? Re MB  12.7
  • Re MB: Capacity  12.8
  • Re MB: Reasonable force 12.9
  • Re MB: Interests of foetus 12.10
  • Re MB: Procedure 12.11
  • The solution imposed – St George’s Healthcare NHS Trust v S 12.12
  • C The Court of Appeal and Court of Protection guidelines 12.13
  • Court of Appeal Guidelines 12.13
  • Court of Appeal Guidelines with the MCA in force 12.14
  • Court of Protection Guidelines: NHS Trust 1 and NHS Trust 2 v FG  12.16
  • Court of Protection guidelines for obstetric cases: procedure and evidence 12.17
  • Notifying the patient  12.19
  • The timing of applications and delay 12.20
  • Planning in advance 12.21
  • Contingent declarations  12.22
  • Advance decisions  12.24
  • Management of pregnancy in women who are comatose or in a permanent vegetative state 12.25
  • Forcible transfer to hospital for delivery 12.26
  • D A suggested procedure for obstetric units 12.27
  • Assessment of capacity  12.28
  • Advice to patients about nature of possible treatment  12.29
  • Discussion with patient about possible loss of capacity 12.30
  • Liaison between teams 12.31
  • Advance decisions  12.32
  • Psychiatric referral and assessment where capacity in doubt 12.33
  • Contingency planning for court application 12.34
  • Compliance with court guidelines 12.37
  • Continual advice to patient 12.38
  • E Procedure for patients 12.39
  • F Conclusion 12.40
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