HOWZAT

Penney Lewis, Professor of Law at King’s College London, said: “This goes further than previous cases. There have been several cases where courts have approved the sterilisation of people unable to give consent, sometimes because the person is unable to cope with the impact of menstruation.

“But this is different, in that the mother appears to be seeking a pre-emptive operation, so that the girl does not experience menstruation at all.”

She said that courts were increasingly cautious about sanctioning such a step unless it was the only possible remedy. The case did not technically need to go before a court, if a person with parental responsibility consented. “In practice, though, they do tend to come to court unless there is a very strong medical case in favour — for example, uterine cancer.”

In making a decision, courts would also take heed of published guidance from the Official Solicitor, who has responsibility for vulnerable adults, that such decisions would look to evidence of a person’s being unable to cope (such as with menstruation) and her sterilisation being justified.

“But in this case, we are talking about how the girl might be affected, rather than concrete evidence. So it is pushing the boundaries.”

A highly relevant case is a Court of Appeal ruling in 2000 involving a 29-year-old patient with severe learning difficulties who was distressed by her periods and had a phobia about hospitals. The mother applied for a declaration that sterilisation would be lawful and it was argued that pregnancy would be highly detrimental to the woman. But the judge ruled that it was in the woman’s best interests instead to have the contraceptive coil inserted, which would prevent pregnancy and reduce menstrual flow.

Russell Levy, a leading solicitor in medico-legal cases with Leigh Day & Co, said: “It entirely depends on the circumstances as to whether it would be right to do this operation.” What was not in doubt, he added, was that the decision should be made by judges — appraised of all the circumstances and with someone representing the teenager's best interests. “In some circumstances, it might be right that to alleviate suffering, such an operation should be done. But it is a very fine line.”

The problem in such a case, he points out, is that it comes perilously close to the idea of forced sterilisation of the mentally ill, to stop them having sex.

Or, as one of the charities put it, to taking action on the ground of social convenience rather than strict medical necessity — a move that would set a dangerous precedent. Andy Rickell said: “Society should adapt itself to include disabled children, rather than their being ‘modified’ to fit society.”

When the case comes to court, judges will have general principles in mind. But they will make their decision on the facts of the case before them. Meanwhile, Miss Thorpe insists that she has her daughter’s best interests at heart, saying that she would suffer more if allowed to develop into an adult. “Please realise,” she told Sky News, “I am not advocating this as a blanket policy for disabled children. For my daughter this, I think, is the right decision and a decision that we have thought long and hard about.”

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