Court of Protection rule on best interests contraceptive patch case

The recent case of The Hospital Trust and Miss V & Others [2017] EWCOP 20 before the Court of Protection highlighted the application of the best interest’s principle in extremely sensitive surroundings.

The case concerned Miss V, a 21 year old lady with severe learning difficulties. The Court noted as background to the case that in late 2015 Miss V had “conceived a child, in circumstances which in all probability amounted to rape”.  After being born, the child was placed in foster care by the Local Authority.

An application had then been brought by the Hospital Trust to the Court of Protection on the grounds that it would be in Miss V’s best interests to be subject to contraception in addition to an existing and robust safeguarding package in place.

The Official Solicitor, representing Miss V and her mother Mrs W, argued that the safeguarding package was already sufficient in protecting her from further harm. Any contraception was disproportionate and not in her best interests.

During the hearing it was established that Miss V lacked capacity to consent to sexual activity and had no understanding of her previous pregnancy and the changes her body experienced. She was however extremely distressed by the ordeal, especially when her baby was removed. The Court also heard that Miss V would often ask where the baby was and would even lash out at her own mother in response. There were even episodes of self harm.

It was therefore imperative that all steps were taken to minimise the risk for Miss V as to ensure she would not fall pregnant again as doing so would have had “dire consequences” for her.

Whilst it was accepted that the safeguarding plan that had been in place for around 12 months had been a partial success, there were still some gaps where Miss V had been left alone without supervision. Due to Miss V’s lack of awareness, limited recognition of danger and having no understanding of the need to be accompanied when out in the community, she was at significant risk of harm and potential further sexual exploitation.

The application of contraception could mitigate further the potential adverse psychological effects that Miss V would experience if she were to fall pregnant again.

The Judge ultimately agreed to this provision, subject to a 6 month review and careful monitoring of any side-effects of the contraception. It was felt that it was in Miss V’s best interests to undergo the procedure as an additional safeguard to the package of care and supervision that was already in place.

This case highlights the sensitivities and careful balancing act the Court of Protection deals with when considering a vulnerable persons best interests. Here the Court had to weigh up Miss V’s own personal freedoms, proportionality and limited choices that she could make against protecting her from further harm in the future.

As with many health and welfare declarations there is never a right or wrong outcome, just what, based on the evidence was in that person’s best interests at that given point in their life.