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Vasectomy ‘overwhelmingly’ in best interests of vulnerable father

Judge orders sterilisation for man with severe learning difficulties to prevent more children

19 August 2013

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A man with learning difficulties who did not want any more children has been ordered to have a vasectomy, making him the first male in England and Wales to be lawfully sterilised for non-therapeutic reasons.

The 36-year-old, known as DE, already has a child with his girlfriend (PQ), who also has learning difficulties.

In June 2012, an NHS Trust applied for declarations that would allow a vasectomy to take place.

Mrs Justice King considered DE's wishes and ruled it was "overwhelmingly in [his] best interests to have a vasectomy".

She said: "Dr Milnes [independent consultant] regarded the most magnetic factor in favour of a vasectomy as being DE's desire not to have any more children.

"It is undoubtedly a magnetic factor carrying considerable weight, but in my judgment, 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."

King J looked how section 4 of the best interests appraisal was applied in a number of reported cases including whether risk management was better than invasive treatment.

DE has lifelong learning disabilities with an IQ of a six- to nine-year-old. He is completely dependent on his parents.

They were unhappy about his long-term personal relationship suggesting "he had been sexually exploited by PQ".

The birth of the couple's baby in 2010 caused "distress" for DE and his parents, who were given special guardianship for the child.

The parents took their concerns about the possibility of a further pregnancy to DE's GP in 2010 and were referred to a consultant who decided a vasectomy was not in DE's best interests "but if the court thought it was the right thing I would be willing to carry out the procedure".

King J reviewed the impact of another child on DE's parental ties and independence.

She also deliberated over his private life taking into consideration that DE's social worker described his relationship with PQ as "remarkable" and one that "should be valued and protected".

King J concluded: "If another child was born not only would DE be deeply distressed but a removal of the child from PQ would be very likely to result in the breakdown of the relationship."

The surgical procedure was found to be the only argument against the application with the judge adding that her ruling had not been taken lightly.

"The fact that the procedure to achieve this is routine, commonplace and safe should not ever be allowed to mask or minimise that bald fact when a court is considering such an application," she said.

The only other known case of its kind is Re A (Medical Treatment: Male Sterilisation) [2000] 1 FLR 549, [2000] 1 FCR 193, which was refused.

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Vulnerable Clients