Consent – incapacity – best interests – sterilisation
A doctor acting to the required standard of the principles set out in Bolam (ie in accordance with a responsible and competent body of relevant professional opinion), had a second duty to act in the best interests of a mentally incapacitated patient. It was for the court to decide whether it was in the best interests of the patient that an operation be performed. “Best interests” encompassed medical, emotional and all other welfare issues and related to the mentally incapacitated person, not to his carers or third parties generally. The case had to be proved that an operation to sterilise was in the best interests of the person unable to consent. The court drew a distinction between the sterilisation of a male and that of a female, stating that there was no direct consequence for a man of sexual intercourse, other than the possibility of sexually transmitted diseases.