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Judge ordered girl to have heart transplant

Robert Verkaik,Jeremy Laurance
Thursday 15 July 1999 19:02 EDT
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A JUDGE'S decision to allow doctors to override the wishes of a 15-year-old girl so they could perform a life-saving heart transplant followed an 11th hour intervention by the Official Solicitor.

Peter Harris was called in by a court in Newcastle to represent the interests of the girl after she refused to accept the advice of heart specialists at the Freeman Hospital in the city that she needed urgent surgery. Mr Harris concluded she was not capable of making a "sound judgement" about her plight. Mr Justice Johnson said the operation could go ahead and the girl had the surgery this week. A hospital spokesman said yesterday she was recovering and her family were at her bedside.

Mr Harris said: "She was confused by her situation and could have been overwhelmed by her circumstances. I told the judge that, and I felt her statements were equivocal." He said he had regarded her as an adult who lacked mental capacity to give her consent to the operation. "She was not in a position to form a sound judgement so I asked the court to get a declaration to overrule her refusal."

The girl, referred to by the initial M, was interviewed by a lawyer appointed by Mr Harris. She told him she did not want the transplant but she also did not want to die. "It's hard to take it all in. I feel selfish. If I had the transplant I wouldn't be happy. If I were to die my family would be sad."

She said if she had to make a similar decision for her own children she would not let them die. "Death is final - I know I can't change my mind. I don't want to die, but I would rather die than have the transplant and have someone else's heart, I would rather die with 15 years of my own heart."

It is an offence to provide medical treatment to an adult without their consent and any doctor who does so may by guilty of assault. In the case of minors under 18, their wishes must be taken into account, according to their intelligence and capacity to understand, but are not overriding.

The British Medical Association said the legal and ethical position surrounding such cases was "complicated and confused". Dr Vivienne Nathanson, head of health policy and research, said: "Doctors find these situations very difficult because all their instincts are to provide life-saving treatment, but equally they are very reluctant to override the wishes of an unwilling patient who may not recover as well if treatment has been imposed.

"Legally, a young person of sufficient maturity may give consent to a treatment but any refusal of treatment may be overridden by either their parents or the courts."

The court had earlier been told by John Dark, a transplant surgeon at the hospital, that the girl would have died within a week without a new heart.

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