Judge approves man's sterilisation in legal first

28 Aug 2013

A High Court judge has sanctioned the sterilisation of a man "in his best interests" in a landmark legal ruling.

The 36-year-old, from the Midlands, has learning difficulties and already has a son, born in 2010, with his girlfriend.

Mrs Justice Eleanor King ruled that a vasectomy could take place after hearing that another child could cause the man "psychological harm".

Experts said he was capable of sexual consent but did not have the capacity to make decisions about contraception.

The case came to court because of undisputed evidence that the man - referred to as DE - does not have the capacity to decide whether or not to consent to sterilisation, meaning a judge had to make the decision.

'Relationship strain'

The Court of Protection in London has heard that DE does not want to become a father again.

But he could not be relied upon to use condoms or other birth control methods effectively to prevent pregnancy, the court was told.

Analysis

There have been cases before of women ordered by the courts to undergo sterilisation, but never of a man. That marks this judgement out as a landmark.

But it's unlikely to lead to a slew of other legal requests for sterilisation because the facts in this case were so unusual, with no-one involved opposed to the application.

More than the legal issues, what marks this case out is that it's a heartwarming story of a loving and long-standing relationship between two people with learning difficulties, the potential breakdown of which the judge said would be a "real and enduring loss" to DE.

Mrs Justice Eleanor King's compassion and understanding shone through in the judgement, describing her "utmost admiration" for DE's parents who'd helped him have a life separate from them which included his girlfriend.

In her ruling, Mrs Justice King said DE lived with his parents but had a long-standing, loving relationship with his girlfriend PQ, who also has learning disabilities, but of a less severe nature.

The birth of the couple's first child had had a "profound" effect on both families, and measures were taken to ensure there was no further pregnancy, including keeping the couple apart and supervising any contact between them.

The judge said the couple's relationship "nearly broke under the strain, but remarkably weathered the storm".

DE's social worker, who specialises in looking after disabled adults, had told the court "how very unusual it is to see such an enduring relationship between two significantly disabled people", adding it was "remarkable and very precious and should be valued and protected in their interests".

Mrs Justice King said DE had suffered considerable distress during the separation with his girlfriend and had his confidence shaken by the loss of his independence.

She concluded that another pregnancy would cause "further and probably more serious psychological distress and consequences for DE".

'Re-establishing normal life'

One medical expert had regarded the "most magnetic factor" in favour of a vasectomy as DE's desire not to have any more children.

But the judge said: "Allowing DE to resume his long-term relationship with PQ and restoring to him his lost skills and independence are as important, if not more so, when determining his best interests."

The overall picture, she said, pointed to "re-establishing as normal a life as possible as soon as possible for DE".

Consequently, she said it was now "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.

The application to allow a vasectomy had been 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.

Beverley Dawkins of Mencap said it was a decision that had been reached ''very well'' by the Court of Protection

An application for the sterilisation of a man came to court in 1999 but was refused, making the new ruling the first time in England and Wales a court has sanctioned a man's sterilisation.

Beverley Dawkins, of learning disability charity Mencap, said Britain must not return to "routine" sterilisation of people with learning disabilities seen in the past.

"We know at Mencap that very many people with learning disabilities make very good and loving parents," she said.

A Mencap spokeswoman said "enforced sterilisations" of people with learning disabilities had been "common practice" in the UK in the 1960s.

She said this practice, carried out in long-stay hospitals, become less common in the 1970s but cases still occurred in the 1980s.

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