Dartford And Gravesham NHS Trust v SEB [2021] EWCOP 55

This case involved an out-of-hours application by the Trust for orders in relation to the management of SEB during the birth of her first child.

SEB is a drug user and has been diagnosed with a schizoaffective disorder. She responds well to medication but has a history of non-compliance leading to relapses, which in turn usually lead to psychiatric crises and inpatient care.

SEB attended a detoxification programme in February 2021 but, unfortunately, she relapsed and began using drugs again, thereby placing the baby at risk of foetal alcohol and/or drug dependency. As a consequence, SEB suffered a significant deterioration in her mental health and she became an inpatient in a psychiatric hospital on 23 June 2021. She is currently detained pursuant to section 3 of the Mental Health Act 1983.

Keehan J was asked to determine whether SEB lacks capacity to make relevant decisions; what will be in SEB’s best interests; whether the restraint proposed by the Trust is appropriate and proportionate; and whether there will be a deprivation of her liberty.

The medical evidence all showed that SEB lacked capacity to litigate and to make decisions about her obstetric care and mode of delivery. Keehan J also concluded that it was in SEB’s best interests to give birth by way of Caesarean section and, if needs be, to be restrained during the course of that procedure, and that any deprivation of her liberty was authorised by the Court. As a postscript he noted that the planned Caesarean was undertaken without the need for restraint, and that both SEB and the baby were doing well.

The full judgement can be read here

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