Letter: A woman's right to refuse obstetric surgery

Sir: The British courts have just ordered a compulsory Caesarean section against the wishes of the mother. Note should be taken of the American experience.

A nationwide survey in the US in 1987 showed that in more than 20 similar cases where the attending obstetricians sought a court order, the judges granted the petition in 86 per cent. These women were forced to submit to major surgery in what was perceived to be the interests of a second patient - the foetus.

In that same year the tragic case of AC came to court. She was dying of widespread cancer but was 26 weeks pregnant. A court order was obtained by the hospital so that a Caesarean section could be carried out and the foetus given a chance to live, even though AC and her family had made it quite clear that they did not want surgery. The baby lived for two hours and AC died two days later, her death undoubtedly hastened by the operation.

The outcry that this event created led to a national debate. The important issue involved necessitated this case reaching the Court of Appeal, even though AC was dead. The decision was reached in 1990, as cited in your legal report (14 October), but the opinion was completely contrary to that quoted. Judge Terry stated that if the woman's wishes had been determined to be against surgery, then her control over her own body and the foetus within her was paramount under the law. This was endorsed by the American Medical Association Board of Trustees' guidelines issued in 1990.

If court-ordered obstetric procedures become more common, the public image of hospitals may be adversely affected and women may choose to deliver elsewhere. Those women most in need of care may be driven away, and more harm than good result.

Yours faithfully,

LINDA M. STANTON

New Barnet, Hertfordshire

14 October